library loan release

Form

Please fill out completely and submit to Director Steven Cook

 

I hereby lend the following items to the Starr Library for the period stated. I release the library from responsibility for the loss, damage, or destruction of the items while they are in the possession of the library.

Loan to extend from                                 to

Items loaned (continue on back of page, if necessary):

 

Name of lender

Address

City                                            State                 Zip

Telephone                                                          E-mail

Signature                                                            Date