WSISD 5-8 Instrument Usage Form 2022-2023
This form is for students that will be using a school-owned instrument for the 2020-2021 school year. This includes: piccolo, oboe, bassoon, bass clarinet, tenor saxophone, baritone saxophone, french horn, euphonium, & tuba.

Student and Parent agree to the following:
-Return instrument and all parts in the same condition, considering normal usage.
-Be responsible for the instrument at all times, on campus or off campus.
-Pay for all damages incurred above normal wear.
-Return the instrument when directed to do so by the band director(s).
-Replace the instrument with one of equal or greater value if it is lost, stolen, or damaged beyond repair.
-Do not allow anyone else to use or take the instrument/equipment.

The student and parent/guardian should fill out this form together.
Sign in to Google to save your progress. Learn more
Student WSISD ID (Lunch) #: *
Student Last Name: *
Student First Name: *
Campus: *
Instrument *
If other, please specify
Parent/Guardian First and Last Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
I, the student, understand that I am responsible for the instrument being checked out to me. I have read and understand the information and responsibilities listed at the top of this form; including, but not limited to: The instrument is assigned only to me and no one else is able to use it. If there is any damage, I understand that I will be responsible for the cost of fixing the instrument.   *
Student: If you agree to the above question, please type your first and last name below as your digital signature. *
I, the parent, understand that my child is responsible for the instrument being checked out to them. I have read and understand the information and responsibilities listed at the top of this form; including, but not limited to: The instrument is assigned only to my child and no one else is able to use it. If there is any damage, I understand that we will be responsible for cost of fixing the instrument.   *
Parent/Guardian: If you agree to the above question, please type your first and last name below as your digital signature. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of White Settlement ISD. Report Abuse
Google Forms