Dalton State College
Derrell C. Roberts Library
Exhibit Loan Agreement & Release Form
Derrell C. Roberts Library thanks you for your willingness to temporarily lend items for exhibit within the library (please attach a list). As a security measure we agree to keep all display items within a locked case. The Roberts Library and/or Dalton State College is not responsible for any damaged, lost, or stolen items.
It is the responsibility of the lender to: 1) insure the items; 2) provide a list of the items; 3) bring the exhibit items in on ____________ ; 4) pick up the items on ____________ ; and 5) dispose of unwanted exhibit items
If any items are not collected by the pick up date, a courtesy call will be made. However, if the lender should then fail to pick up the items the library will not be responsible for returning materials.
Please fill in the below information:
Name of Lender: _________________________________________
Address: __________________________________________
__________________________________________
Phone number: ____________________________
Name of person who may pick up items other than the lender: _______________________
Phone number for this individual: _______________________
I, the undersigned, hereby lend the following items to Roberts Library for exhibit purposes only. In consideration of the privilege of exhibiting them in the library, I hereby release said library from responsibility for loss, damage, or destruction while they are in the possession of the library.
Description of items loaned:___________________________________________________
List attached: ___ yes ____ no
Signature:__________________________________________ Date:________________
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Items have been picked up by: ________________________________ on ____________
Name Date
Items released by: ____________ on _____________
Staff initials Date
Approved by DSC Library Advisory Committee
November 10, 2008