Last modified: March 21, 2022
Instrument Rental Agreement
Dixon Middle School Instrument Rental Agreement
Student Name__________________________Parent/Guardian__________________________ Instrument_____________________ _Serial Number__________________________ Condition_______________________Dates of Use__________________________
We have a very limited supply of school owned instruments. Great care must be taken to ensure that these instruments are kept in good condition.
The rental cost for guitar and percussion classes is $40.00 and the cost for band class instruments is $75.00.
The rental fee will not be refunded if a student withdraws from the class or loses the privilege of using the instrument.
Supplies such as guitar strings, neck straps, reeds for woodwind instruments, cork grease, valve oil, swabs, cleaning snakes, etc. are to be provided by the student.
Student is responsible for the appropriate care and cleaning of the instrument. Instruments will be inspected for cleaning and maintenance at the end of each semester. Brass and woodwind students who do not clean their instruments at the end of the year will be charged the cost for having the instrument cleaned.
Student is not to allow others to play on or with the instrument.
Student/Parent will be responsible for the cost of repairs if the instrument or case is damaged by abuse and/or neglect. (Failure to appropriately store the instrument will be considered neglect)
Student/Parent is responsible for the cost of the instrument if it is lost or stolen.
A student who demonstrates a lack of responsibility for a school instrument will lose the privilege of using the instrument.
Instrument must be returned to the teacher before withdrawing from the class. All instruments will be returned at the end of the course.
We have read, understand, and agree to the terms of this instrument rental.
__________________________________ ______________________________
Student Signature Parent/Guardian Signature
Office Approval___________
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