Online Rental Form - Victor Litz

Online Rental Registration Form

Use this form to speed the rental process. Rentals available in store or by phone. In store pickup, curbside pickup or same day / next day local delivery.

Form must be filled out completely. Further information will be required such as credit card/debit card. We will contact you to confirm availability and options. MUST HAVE PROPER IDENTIFICATION AND A MAJOR CREDIT CARD. Debit card will require a deposit. Rental instruments are available immediately for in store pick-up. Delivery is available as low as $19.95. This is a rental registration form only. You are welcome to do the entire process in store in person. In store rentals only take about 10 minutes. In most situations we can process your on-line rental registration form and have an instrument ready with in 1-2 hours. During the peak of the rental season it may require 24 hours to up date in our system. If you have any questions please give us a call! 301-948-7478

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Phone (Different)(Required)

Email(Required)

Enter Email Confirm Email

Employer's Name (If Self-employed, name of business)(Required)

Employer's Address(Required)

Spouse's Name/Next of Kin(Required)

Spouse's/Next of Kin Cell Number(Required)

Spouse's/Next of Kin Work Number(Required)

Spouse's/Next of Kin Employer & Address(Required)

Spouse's/Next of Kin Email(Required)

Students's Name

Student's School

Drivers License Number(Required)

State(Required)

Initial Rental(Required)

9 Month

1 Month

LEVEL 1 INSTRUMENTS-Flute, Clarinet, Trumpet, Cornet, Trombone, Violin, Viola, Snare drum, or Bell Kit 9-month Plan - $129.99 1-month Plan - $29.99

Yamaha/Upgrade 9-month Plan $189.99

LEVEL 2 INSTRUMENTS- Alto Sax, Piccolo, Cello, Curved Headjoint Flute, Open Hole Flute, Snare/Bell Kit Combo 9-month Plan - $249.99 1-month Plan - $39.99

LEVEL 3 INSTRUMENTS- Tenor Sax, French Horn, Oboe, Baritone Horn 9-month Plan - $249.99 1-month Plan - $49.99

LEVEL 4 INSTRUMENTS- Alto/Bass Clarinet, Bass, Tuba, Bari Sax 9-month Plan - $399.99 1-month Plan - $79.99 1 Month rentals require a $100 deposit

Damage Coverage(Required)

Yes

Damage Coverage covers repairs and maintenance needed from normal use and from accidental damage. Does not cover loss from cause, gross negligence, unauthorized repaired attempts, mouthpieces, strings, bridges, bow hair or accessories. By declining DC, you agree that you are responsible for all maintenance and damage to the instrument.

Instruments(Required)

Upgraded or Yamaha

For upgraded or yamaha instruments are more money.

Violin Size(Required)

1/4

1/2

3/4

4/4

If you know your students size pick one here. If you do not know your students size typically 4th graders are a 1/2 size and 5th graders are a 3/4 size. If you get the wrong size we can exchange if we have availability.

Viola Size(Required)

12 inch

13 inch

14 inch

15 inch

15.5 inch

16 inch

16.5 inch

If you know your students size pick one here. If you do not know your students size typically 4th graders are a 12inch and 5th graders are a 13inch. If you get the wrong size we can exchange if we have availability.

Bass Size(Required)

1/8th size

1/4 size

1/2 size

3/4 size

4/4 size

complete with gig bag/case and bow

Cello Size(Required)

1/4

1/2

3/4

4/4

Basic accessories needed.

Rosin $2.99

Shoulder Rest $19.99

Accessories for rental instruments are extra.

Basic accessories needed.

Rosin $2.99

End Pin Rest $9.99

Accessories for rental instruments are extra.

Basic accessories needed.

Slide Grease $2.95

Slide Oil $2.95

Accessories for rental instruments are extra.

Basic accessories needed.

Reeds

Cork Grease

Cleaning Brush

Polishing Cloth

Accessories for rental instruments are extra.

Basic accessories needed.

Clarinet Kit/ 4 #2 Reeds, Cork Grease, and a Swab $19.99

Accessories for rental instruments are extra.

Basic accessories needed.

Saxophone Kit/ 4 #2 Reeds, Cork Grease, and a Swab $19.99

Accessories for rental instruments are extra.

Accessories (optional)

Music Stand $19.95

Polishing Cloth $5.99

Essential Elements Book Mont. Co. Schools $12.95

Care Kit $19.99