TLU CMA INSTRUMENT RENTAL AGREEMENT FORM
Please complete a separate form for each instrument that you are renting.
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Student Last Name *
Student First Name *
Class Student is Enrolled In - check all that apply *
Required
Instrument you are renting *
Instrument size (if known, should be on instrument case). Otherwise, leave blank.
Instrument Number (Should be on instrument case). If unknown, leave blank.
Parent/Guardian Last Name *
Parent/Guardian First Name *
Parent/Guardian phone number *
Parent/Guardian Email *
Home mailing address *
By clicking below, I am indicating that I am responsible for paying for loss or damage to this instrument. I also agree to inform my instructor or the director of any problems with the instrument when they occur, and to return it clean, with accessories when requested. If we need to discontinue the class at any time, I agree to return the instrument to the instructor. *
I have indicated below how I am paying the instrument rental fee of $20: *
Today's Date *
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