You must have JavaScript enabled to use this form. CAMERAS NOT RETURNED BY THE LAST DAY OF CLASS WILL RESULT IN YOUR RECORDS BEING HELD. Must show payment receipt to receive camera. NO CASH IS ACCEPTED. Please allow 24 hours to process and prepare your camera for rental How-to Tutorial Video Photography Equipment Loan Agreement Instructor Student's Name ID# Email Address (One that you check daily) Phone Number Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederate States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming ZIP/Postal Code Description of equipment on loan By signing below I acknowledge that I have borrowed the listed equipment from the photography program, and take full financial responsibility for such equipment. I will replace the equipment if lost or stolen, and pay for any repairs if broken when the equipment is in my care. I agree to return the equipment on time in the same condition I received it. I understand that a hold will be placed on my CSUSB official records and I will not be able to register for classes, get grades, graduate, and / or order copies of my official transcripts if the above conditions are not met. Student Signature Sign above