eReader Loan Agreement



I have read the LaGrange County Public Library’s eReader Borrowing Policy and hereby:


·        understand that I must have the LaGrange County Public Library as my home library, be at least 18 years of age, have a library card in good standing, and I must give the staff member a valid Driver’s License or State ID (with my correct address on it) to copy if I borrow a eReader;

·        understand that the length of checkout for the eReader is 3 weeks;

·        agree to not allow anyone else to borrow or use the eReader or allow children to play with the eReader;

·        agree to return the eReader with all the cords & accessories given to me at the time of checkout;

·        agree to pay overdue fines of $.25 per day if I do not return the eReader on time, and understand that I will be billed the $200.00 replacement cost for the eReader if I fail to return it;

·        agree to be cautious with the eReader and keep directly away from any water or liquids and will return the eReader to a checkout desk in the condition I borrowed it in;

·        understand that I cannot return the eReader to the drop box but must return it directly to a checkout desk, and that I will be billed a minimum of $25.00 up to the full price of the eReader for any instances that I return it in the drop box;

·        understand that if I return the eReader, or any of the borrowed cords or accessories, damaged I will be charged a fee for the damages up to the replacement price ($200.00) of the item(s);

·        understand that if I do not follow any of the above stipulations my eReader borrowing privileges may be revoked.     


By initialing I understand that I am verifying receipt of each item below:


____________ eReader             __________  USB Cable

____________ eReader Case    __________  Power Adaptor




I have read and agree to abide by the LaGrange County Public Library eReader Borrowing Policy. I also understand that if I do not abide by the policy I will no longer be allowed eReader borrowing privileges.


______________________                       _______________________        ___________

Printed Name                                                Signature                                           Date


This form must be signed in the presence of a Staff member at the Main Circulation Desk.



Staff Check-out Procedure:


____ Reader is functional at the time of check-out           

____ All parts are in the bag (eReader, case, USB cable, power adapter)

____ Reader is fully charged at the time of check-out  

____ Confirm patron is a LCPL patron

____ Copy I.D.                                                      

____ Attach I.D. copy to form


Staff Member ___________________________                 Date _________________



Staff Check-in Procedure:


____ Reader is functional at the time of check-in

____ Reader has all parts present at the time of check-in

                   ___ eReader   ___case   ___ USB cable   ___ power adapter

____ Reader and all accessories are in good condition

____ Reader was returned to circulation desk and not in drop box

____ If any damages occurred, fine(s) placed on patrons account and comments recorded below:


Comments: _________________________________________________________________






Staff Member _______________________________  Date ________________

Written 10/04/2013
Reviewed 04-13-2015