RRISD School Owned Instrument Usage Form 2020-2021

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***Students using school owned instruments must have this form on file.***

Due to their large expense, oboes, bassoons, tenor saxophones, baritone saxophones, French horns, euphoniums, tubas, and large percussion equipment are instruments provided to students on loan by Round Rock ISD.

All district-owned equipment must be handled appropriately. Students are responsible for the proper care and maintenance of their district-owned instruments - up to and including the cost of any repairs - in the event that the instrument is damaged through negligence while on loan from the district.

***PLEASE NOTE: For 2020-2021, RRISD has waived the $50 maintenance and usage fee for the school-owned instruments listed above.

Email *

School and Program *

Deerpark MS Band

Required

Student Name (First and Last) *

Legal Guardian Name (First and Last) *

Address

Zip Code

Contact Phone *

Contact email *

Select the instrument being checked-out from RRISD *

Brand (To be completed by director)

Model (To be completed by director)

Serial Number (To be completed by director)

Replacement Value (To be completed by director)

Accessories Provided (To be completed by director)

I understand and agree to all of the following - (must check all boxes) *

The student and parent/guardian are responsible for providing their own accessories for the instrument, including mouthpieces and reeds.

The student and parent/guardian are responsible for loss and/or damage to the musical instrument while it is in the possession of the student.

Insurance is not provided by the school district for any instrument. Families are encouraged to insure the instrument though their homeowners policy via a rider.

Required

By checking the box below I acknowledge that all the information detailed above is accurate and correct. *

I understand and agree to the terms detailed above

Required

Send me a copy of my responses.

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