I, the undersigned, having received the instrument described above, agree to observe the following as conditions for my use of it:

I accept full responsibility for loss or damage.

I will not permit this instrument to be used by anyone else and will not leave it where others might have access to it.

I will use it only in connection with instruction, ensembles, or activities sponsored by or approved by the faculty member authorizing its use.

I will take proper care of it by keeping it clean and reporting anything that may need attention.

I agree to return the instrument at the designated time.

I understand that this instrument is supplied for my use as a convenience to me and not as an obligation of the _______________ Department of Music. I further understand that any violation of this accepted responsibility as determined by the faculty member authorizing its use, will forfeit the privilege of using this instrument, and that the instrument must be returned at any time upon demand.