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Student Media Equipment Request Form

Store Room (C215g/C304a) Monday to Friday Booking Times 9:15am – 1:45pm


Please note the grey areas of this form are to be filled out by a technician.
Group Cour
Name: Thompson Productions se: Level 2 Media

Student Year
Number: 5240084 : 2022

Booking time slot

Date / Time Out: 16th March 2022 Date / Time In: Aprill 1st 2022

approv approve
Equipment Description No. Asset # e
Description No. Asset #

Camera
Cannon 60D 1

Cannon 70D 1

Cannon 80D 1
Lens
Macro 1

Micro 1

Tripod / Rigs
3x tripods for camera 3

Audio
ZOOM recorder 1

Shotgun mic 1

Lighting
Lighting kit 1

Memory card
32gb 3

Battery
Canon batteries 5

AA batteries 6
Charger
Camera charger 5

Other
I understand that I will be fully responsible for the equipment whilst it is in my care and understand that failure to return equipment in the agreed timeframe will result in my
privileges being withdrawn. In the event of any loss or damage to the loaned equipment whilst in the care of the named students, GC reserves the right to charge student(s) for
replacement or repair. It is advised therefore that the replacement value of any GC equipment is considered and an assessment of risk is undertaken before undertaking a project.
The final decision with regard to any fees chargeable will be made by the Head of Academy in all instances.
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Student Signature: Notes:

Collected: Teacher: Tom George Strike Note: Date: Time:

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