Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I agree to the following rental conditions: *

Please read carefully and check the boxes to sign

The rental fee will be billed to the credit card on file monthly on the day indicated below

To assume full liability for the instrument during the rental period

The rental fee only covers normal use of the instrument, not maintenance or repair costs beyond normal wear and tear. Russo Music will provide a referral to approve repair persons in all other insurances

The instrument must be returned in the same condition as it was issued

No refunds (whole or partial) will be issued for the rentals returned early

Today's Date *

MM

DD

YYYY