School Year Instrument Rental

School Year Instrument Rental

This form must be completed by a parent for music students in grades 3-6, intending to retain their instruments over the school year.
Parent Name*

First NameLast Name
Parent email*
example@example.com
Child's Name*

First NameLast Name
Child's current grade

School Year Instrument Rental Payment:

School Year Instrument Rental$150.00

For all students, grade 3-6 not returning their instruments to Highland Hall for the school year.

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

The rental period for this instrument is for the duration of the 2020/21 school year. I understand that it is my responsibility to look after it and I agree to return it in the same condition that it was on the day I rented it, normal wear and tear excepted.

I understand that there is a $150 charge for the rental of the instrument. However, in the event that the instrument is lost, damaged or destroyed during my rental I agree that I will replace or repair it.

I understand that Highland Hall and its employees are not representing that my child is fit to use this instrument with or without my supervision. I accept full responsibility for my child's use of this instrument at home.
Parent Signature

Clear
Should be Empty: