Instrumental Agreement Form 
I agree to see that the instrument loaned to me is properly cared for and returned when requested. I
agree to pay the rental fee of $100 per year as set by Wasatch County Schools for the current school year
(Please make checks payable to WHS Band). This fee covers basic maintenance and normal wear of the
instrument only and should be paid in the fall at the beginning of the school year.. The fee will not apply to any repair or replacement costs should the instrument become
damaged, lost or stolen. In case of loss or any damage to the instrument while loaned to me, I will
immediately notify the director. I understand that no repairs are to be undertaken without the express
permission of my  music director. I further agree to pay for the repair and/or replacement of the
instrument should I be found to have intentionally damaged the instrument or to have not maintained
the instrument properly (gross negligence). In addition, I agree that the instrument will be returned on demand
to the director without recourse or refund. Students should also not lend or rent the instrument or permit the
lending or renting of the instrument to another person.
I fully understand and agree to the terms of this rental agreement.
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Student's Name (first and last) *
Student Email
Parent's Name (first and last) *
Email (parent email) *
Phone number (parent phone) *
Instrument/Instruments *
Did I give serial numbers of these instruments to Mr. Ryszka to record?
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Condition *
Included Accessories: *
Required
Comments
My Parent will be notified by this week that I need a school instrument and that it costs $80 for the year and the rental agreement terms. *
By clicking below I demonstrate that I fully understand and agree to the terms of this rental agreement.   *
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