1. Keshequa Mountain Dulcimer Learning Group
  2. Loan Agreement Form
    1. Parent or Guardian’s names
    2. Contact information (mailing address, phone number, email)


Keshequa Mountain Dulcimer Learning Group

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Loan Agreement Form
 

The Keshequa Mountain Dulcimer Learning Group has some student dulcimers which can be taken home by the students for a 1 week period. These dulcimers are available on a first come basis. Students are eligible to borrow a dulcimer when they return this sheet signed by their parents or guardians. If no dulcimer is available at the time, they will be put on a waiting list. When they return the dulcimer after 1 week, they will then be eligible to borrow another dulcimer.
Please read the agreement guidelines below and then sign and return the documents.
 
Student Name      Grade
 


Parent or Guardian’s names



Parent or Guardian’s names
 
 


Contact information (mailing address, phone number, email)



Contact information (mailing address, phone number, email)

 


 
Dulcimer Borrowing Guidelines
1. There is no charge for borrowing the dulcimer.
2. The dulcimer will be returned to Mr. Cook no later than one week from the time it was borrowed
3. We will follow the “Care and Feeding of Dulcimers” Guidelines found in the dulcimer bag.
4. If the dulcimer is lost or damaged, we will pay for the replacement ($50) or repair of the instrument. (If the cost of repair exceeds $25, the dulcimer will have to be replaced.)
5. Dulcimers can be picked and returned either by students (be careful on the bus!) or by parents. Parents should make arrangements with Mr. Cook to pick them up. They can be dropped off in the Central Office during the school day or at Mr. Cook’s house (9 Creek Road in the Village) after school hours.
6. Students who fail to return the dulcimer after one week may be restricted from borrowing another dulcimer.
7. Students can use a dulcimer after school in Mr. Cook’s room any Tuesday –Thursday!
 
We have read and agree to the guidelines listed above.
 
 

Students signature          Parent’s signature       Date

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