Dear Parent or Guardian,

This form must be signed in order for your son or daughter to borrow any video equipment overnight. Once signed, the form will be valid for the 2003-2004 school year or until they are no longer enrolled in avisual communication class. Students must be in good standing (class average, behavior etc.) in order to sign out equipment. If you have any questions prior to signing this form, please contact Mrs. Arena or Mrs. Bloom at 508-528-5600.

The equipment that may be borrowed includes:

Equipment	Approximate Replacement Cost
Canon Digital Video Camcorder (various models)	$800
Canon Digital Video Camcorder (GL2)	$2700
Camera Bags:	$25
Hard case camera bag and equipment for GL2	$100
Tripod (various brands)	$350
Various types of microphones	$100
Batteries for the above equipment	$50

The above prices are approximate. If in the event equipment is not returned in the same condition as when borrowed, you will be charged the replacement cost.

Student Information (to be filled out by student):

Name:                                                                                                         

Year of Graduation:             Period:           

Teacher's Name:                                                                                                         

I,                                                        promise to return the above-mentioned video equipment in working condition (batteries must be fully charged) and accept full financial responsibility for any damages to the equipment or loss thereof.

Parent or Guardian's Name (Please Print)                                                                                                  

Signature of Parent or Guardian                                                                                           

Date                             

All equipment must be returned before the start of the next school day. If you are absent, it is your responsibility to return the borrowed equipment to school.