UTM Percussion Instrument Rental Form
Note: This form is a request for rental and will be reviewed by UT Martin Faculty and Staff. There is no guarantee that instruments will be available for rental.

Please fill out all * required items below and leave all items at the bottom of the page blank to be filled out by Faculty or Staff at the time of instrument pickup.

Name *
First and Last
Your answer
Phone No. *
Your answer
Email Address *
Your answer
Instrument *
Please use a separate form for each instrument if you are requesting multiple.
Institution Name *
Your answer
Address Where Instrument Will Be Housed *
Your answer
Intended Use *
Your answer
Requested Rental Duration *
Ex: Fall Term, 1yr, 1 month, etc...
Your answer
Requested Date for Check Out *
MM
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DD
/
YYYY
Probable Date for Return *
MM
/
DD
/
YYYY
Additional Questions or Information
Your answer
Information below to be filled out by UT Martin faculty or staff at time of instrument pickup and/or return
Rental Price
Payment should be made at time of instrument pickup by check. Checks should be made payable to UTM Music Department.
Your answer
Serial No.
Your answer
UT Tag No.
Your answer
Instrument Condition at Pick Up
Your answer
Instrument Condition at Return
Your answer
Replacement Value
Your answer
Terms and Conditions
By signing this form you agree to all terms and conditions outlined here within. This form and signature constitute a rental agreement between UT Martin and the signing party.

If instrument is damaged beyond repair, lost, stolen, or not returned to UT Martin, the signing party is solely responsible for the agreed upon replacement value of the instrument. If the instrument is not returned in equal condition, the renter will be responsible for any repairs/replacement parts at any additional cost. All repair/replacement parts must be approved by The UTM Department of Music.

This would include, but not restricted to the following: Wheels, Bars, Rails, String, Frame, and Resonators.

UT Martin shall not be held liable for any injury, damages, repairs, or loss of income or performances due to instrument malfunction or for any other reason not listed.

Payment should be made at time of instrument pickup by check. Checks should be made payable to UTM Music Department.

This contract shall be legally enforceable through the doctrine of Promissory Estoppel.

Additional Payment Terms If Applicable
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Signatures
To be signed at time of instrument pickup
Signature and Date of Borrower (to be signed at pickup)
Your answer
Name of UTM Representative
Your answer
Signature and Date of UTM Representative
Your answer
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