• HHS Audio and Video Technology and Film
     
    Studio Request Form

    Please use this form to request studio time. Please note that you are responsible for all
    equipment used in the studio. Vandalism
    will result in immediate dismissal from class with further review by school
    administrators.

    You must arrive no later than 10 minutes after your request
    time. Failure to do so may result in
    loss of studio privileges.


    Name:
    _____________________________________________________________________________


    Group/Project:
    _____________________________________________________________________________



    Date of studio request: ______________________ Time of studio request:______________________


    ______________________________________________________________________________________________________________________________________

    HAMPTON HIGH SCHOOL -AVTF

    FIELD EQUIPMENT - USER CONTRACT AND CHECKOUT FORM

     

    Name (please print) __________________________________________ Home Phone _______________

     

    Date(s) of shoot _____________________ Location(s) of shoot ________________________________

     

    Location Phone Number ________________________  Contact Person  _________________________

     

    * No equipment shall be checked out unless user verifies its proper operation and indicates such by initialing the appropriate space below.

    * Upon check-in, each item must be initialed by a staff person, to indicate that item was returned in proper operating condition.

    * Condition of lamps must be verified at both checkout and check-in.

    * All items should be checked for loose or missing hardware, worn or damaged cords, or malfunctioning electronic or mechanical parts, SD cards etc..

     

    ITEM                                           DESCRIPTION                                      CHECK-OUT          CHECK-IN               NOTES

    CAMERAS & TRIPODS:                                                                                                User                                      Staff

    JVC GYHM150U Camcorder with AC charger and

    battery, 8GB SD card, unit # _____________________                         _______                     _______       ___________________

    Panasonic Camcorder HX-WA03 w/ AC charger,

    8GB SD card, USB cable, unit # _________________                            _______                    _______       ___________________

    GoPro Hero 3+ with waterproof case #  ____________                          _______                     _______       ___________________

    Nikon D3100 DSLR 18-55mm lens, 55-200mm lens,  

    .45X wide angle lens, AC charger and battery _______                          _______                      _______       ___________________

    Manfroto 0558B Tripod # _______________________                          _______                     _______       ___________________

    Cannon VIXIA Camcorder with AC charger #_______                           _______                     _______       ___________________

    ____________________________________________       

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------

    CAMERA STABILIZERS:

    Fig Rig ______________________________________                         _______                      _______       ___________________

    Silver Flyer ______ ____________________________                          _______                     _______       ___________________

    Steering Wheel ________________________________                         _______                      _______       ___________________

    Sm Weighted _________________________________                          _______                     _______       __________________

    Lg Weighted __________________________________                         _______                     _______       ___________________

    Sm 3 handled _________________________________                          _______                     _______       ___________________               

    Lg 3 handled _________________________________                            _______                    _______       ___________________

    ____________________________________________                           _______                     _______       ___________________

                   

    LIGHTING:         

    Lowel Kit # ___ ______________________________                            _______                     _______      ___________________

    Reflective Panel # ____________________________                             _______                    _______      ___________________               

    ____________________________________________                           _______                     _______      ___________________

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------

    AUDIO:

    Sure CVL Wireless Lavalier w/transmitter #   _______                           _______                     _______      ___________________

    Sure MX183 Lavalier # ________________________                            _______                     _______      ___________________

    WM Pro Wireless Lavalier ______________________                          _______                     _______      ___________________

    Sure Hand Held Microphone # ___________________                           _______                     _______      ___________________

    AT 8004L Microphone _________________________                           _______                     _______      ___________________

    Mixer _______________________________________                          _______                     _______      ___________________

    EarTech Wireless Comm. w/chargers & headset # ____                         _______                     _______      ___________________

    Walkie Talkies # ______________________________                         _______                     _______      ___________________

    Zoom H1 w/case, wind screen, tripod, charger, 2GB

    micro sd card and USB cable ____________________                          _______                     _______      ___________________ 

    ____________________________________________                        _______                     _______      ___________________

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------

    ACCESSORIES:

    Matching transformer (type)____________________                              _______                    _______      ___________________

    Adapters ___________________________________                             _______                    _______      ___________________

    Power strips #’s  _____________________________                             _______                    _______      ___________________

    Power cables_ _______________________________                             _______                    _______      ___________________

    Carrying Case/ Baggie ________________________                               _______                    _______      ___________________

    Other: 4 wheeled camera mount_________________                              _______                    _______      ___________________

    Slider w/4 wheeled camera mount_______________                               _______                    _______      ___________________

     4 wheeled camera dolly_______________________                              _______                    _______      ___________________

    ___________________________________________                            _______                     _______      ___________________

    ------------------------------------------------------------------------------------------------------------------------------------------------------------------

     

    EQUIPMENT SHALL BE RETURNED:    DAY_____________    DATE_____________ TIME_____________

    Both signatures must appear for this contract to be valid. Be sure to fill out and sign other side.

     

    USER SIGNATURE ____________________________________________ DATE _________________________

     

    STAFF SIGNATURE ____________________________________________ DATE _________________________

     

     

     

     

    HHS Audio and Video Technology and Film 

    Certified User Agreement

     

    In return for the use of this equipment I agree to completely reimburse HHS AVTF for the cost of any repairs (including charges for parts and labor) which are necessitated by any damage to the above equipment during the time it is in my possession, other than damage which is due to ordinary wear and tear in the sole judgment of HHS AVTF.

     

    Additionally, if any piece of equipment checked out by me is damaged beyond repair while in my possession, or is lost or stolen during this check out period, I hereby agree to reimburse HHS AVTF for the full cost of replacing that piece of equipment.

     

    It is understood that equipment cannot be used in violation of U.S. Copyright laws.  I understand that equipment cannot be used in any way for personal projects whether for profit or remuneration to me or not, without the prior consent of the management of HHS AVTF and that I may be required to pay full rental fees based on fair market value as judged by the Henry County School System.

     

    I understand that I may be penalized with a week of no checkouts for each hour that I am late returning equipment. I further understand that all equipment issued to me is due back at the agreed time.

     

     

    User Signature:  ______________________________                  Today’s Date ____________________

     

    Staff Signature:  ______________________________

     

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    TO BE FILLED OUT AND SIGNED BY STAFF PERSON UPON RETURN OF EQUIPMENT:

     

    Date Returned:  _________________________

     

    Time Returned:  _________________________

     

    Staff Signature:  _________________________

     

     

    To be filled out if any problems are noted at check-in, including lateness and reasons why:

     

     

     

     Staff Signature  ___________________________________     Date Signed ______________________

     

    User Signature ____________________________________    Date Signed ______________________