SCPS Instrument Rental Form, 2026-2027

SCPS Instrument Rental Form, 2026-2027
The following form must be filled out by any student that will be using a county/school-owned instrument for the school year. There is also a $100 Instrument Rental Fee that is used to repair and maintain these instruments.
The primary instruments that can be rented from the school are:
- Oboe, bassoon, French horn, baritone, tuba, & percussion
The following instruments may be rented from the school if available:
- Flute, clarinet, alto sax, tenor sax, trumpet, trombone
The following instruments may be rented or assigned to meet instrumentation requirements:
- Bass clarinet, baritone sax, flugelhom, English hom
All percussion students are responsible for this form and the fee for the use of the school's percussion instruments.
Equipment Description
Type of Property (Instrument/Equipment)
Property to be returned by May 31, 2027.
Student Information
Student Name

First NameLast Name
Student ID Number
Parent/Guardian Name

First NameLast Name
Best Phone Number
Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
STUDENT/PARENT/GUARDIAN STATEMENT OF RESPONSIBILITIES:
1. I will take reasonable precautions to maintain the security of the equipment in my home.
2. If the equipment or any of its accessories are lost or stolen, I will immediately notify the police and the school and department mentioned above. I agree to pay the inventory price if the equipment is not recovered or damaged beyond repair.
3. The equipment and accessories will be returned no later than the last day of student attendance.
4. If I experience any problems with the equipment, I will notify the school and department immediately and explain what is wrong with it. If the damage occurred while in my possession, I agree to pay for the repair.
5. I will see that the equipment is used appropriately for the educational purpose intended.
STUDENT SIGNATURE
DATE

MonthDayYear
Date
PARENT/GUARDIAN SIGNATURE
DATE

MonthDayYear
Date
This form and initial payment must be collected before an instrument is issued. If submitting cash, check, or money order, send it to Mr. Langston in an envelope labeled with:
- Student Full Name, Band Assessments, & the amount enclosed
- Make checks out to Lake Mary High School
- Digital payments can be made by visiting MySchoolBucks
Should be Empty:

SCPS Instrument Rental Form, 2026-2027

Equipment Description

Student Information

STUDENT/PARENT/GUARDIAN STATEMENT OF RESPONSIBILITIES: