RRISD School Owned Instrument Usage Form

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RRISD School Owned Instrument Usage Form - Woodwinds/Brass

Students using school owned instruments must have this form on file. A $50.00 yearly instrument usage fee will be assessed. Only fill out this form once, even if your student has an instrument for home and one for school.

School and Program *

Student Last Name *

Student First Name *

Instrument *

Name of Parent/Guardian *

Address *

City *

Primary Contact Phone *

Primary Contact Email *

Payment Options *

Make a check out to "RRISD Instrument Usage". Instrument Usage fee is $50.00.

Pay online by credit card (District will assess a $2.00 fee for credit card processing) - https://roundrockisd.revtrak.net/-web-store-home/Fine-Arts/Middle-Schools/

Request a waiver of the musical instrument usage fee because this student is eligible for free/reduced lunch.

I understand and agree to all of the following - *

Payment of this fee does not guarantee a specific instrument, nor does it reflect a student's placement within their ability based ensemble.

The fee applies even if the student uses a privately owned instrument for "home" use.

The student and parent/guardian are responsible for providing all accessories for the instrument, including mouthpieces and reeds. This includes replacing broken strings on orchestra instruments and guitars.

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.

This fee will be assessed once during the academic year and is not refundable.

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

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