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Sam`s Strings Instrument Rental Form
Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
E-Mail:*
Billing Information
First Name:*
Last Name:*
Middle Initial:
Driver`s License #:*
Address Line 1:*
Address Line 2:
City:*
State:
Zip Code:*
Home or Cell Phone:*
Work Phone:
Students Name*
School*
What instrument do you want to rent?
Availability is on a first come - first serve basis, but we will do our best to accomodate your requests! USED IS RUNNING LOW
New/Like-New or Used*
New
Used
Violin Rental NEW:
  3 months initial rental fee + sales tax
Violin Rental USED:
  3 months initial rental fee + sales tax
Viola Rental NEW:
  3 months initial rental fee + sales tax
Viola Rental USED
  3 months initial rental fee + sales tax
Cello Rental NEW:
  3 months initial rental fee + sales tax
Cello Rental USED:
  3 months initial rental fee + sales tax
Bass Rental NEW:
  3 months initial rental fee + sales tax
Bass Rental USED:
  3 months initial rental fee + sales tax
What Size Instrument Do You Need?*1/4, 1/2, 3/4, etc
Serial Number (if known)
Purchase Accessories with your rental at Promotional Prices!
Do you need a Shoulder Rest (viola 14inch and smaller, please select violin shoulder rest)
Foam Shoulder Rest
  Foam Shoulder Rest (including tax)
Violin Shoulder Rest
  Basic Shoulder Rest (including tax)
Violin Shoulder Rest (KUN)
  KUN brand Shoulder Rest (including tax)
Viola Shoulder Rest
  Basic Shoulder Rest 15" or Larger (including tax)
Viola Shoulder Rest (KUN)
  KUN brand Shoulder Rest (including tax)
Do you need a rockstop (Cello and Bass only)?
Rockstop
  Slipstop rockstop (including tax)
Rockstop
  Xeros rockstop (including tax)
Do you need a metronome/tuner?
Metronome/Tuner combo
  Korg TM-50 (including tax)
TM-50 and CM-200Mic
  Korg TM-50 and CM-200 Tuning Pickup (including tax)
Metronome/Tuner combo
  Intelli 204 (including tax)
Do you need a music stand?
Music Stand
  Hamilton Folding Music Stand (including tax)
Do you need books?
Essential Elements 1
  Essential Elements Book 1 (including tax)
Essential Elements 2
  Essential Elements Book 2 (including tax)
Essential Elements 3
  Essential Elements Book 3 (including tax)
Suzuki Book 1
  Suzuki Book 1 (with CD) (including tax)
Suzuki Book 1
  Suzuki Book 1 (without CD) (including tax)
Sound Innovations
  Sound Innovations for String Orchestra (including tax)
Notespeller
  Notespeller for Violin/Viola/Cello/Bass
Master Theory Book 1
  Master Theory Book 1 (including tax)
Do you need anything else?
Other itemsie. mute, spare strings
Wittner Chinrest
  This is especially popular for younger violin students
When do you need your instrument by?
Date instrument needed by*ie. August 22, 2015
Total
Grand Total:
After the initial 3 month rental period, you will be charged on a monthly basis:

USED
Violin and Viola = $27 ($22 Rental + $6 Maintenance) + tax
Cello = $47 ($40 Rental + $7 Maintenance) + tax
Bass = $62 ($52 Rental + $10 Maintenance) + tax

NEW/LIKE-NEW
Violin and Viola = $30 ($24 Rental + $6 Maintenance) + tax
Cello = $52 ($45 Rental + $7 Maintenance) + tax
Fee Structure and Payment Policy
Rental fees must be paid in advance monthly, and will be automatically deducted from your credit card on file. Rental contracts are Month to Month, with the first 3 months fees being paid at the opening of a rental agreement. This initial 3 month payment is non-refundable, after which the contract continues month to month, until the instrument is returned. Return/Past Due Account Policy 1) Returns: Returns can be made at anytime! To avoid being charged for the following month, instruments must be returned by the last day of the preceding month. In addition, the first 3 months rent are non-refundable, regardless of if you return the instrument beforehand. 2) Past Due Account Policy: You may rent the instrument for as long a period as you wish, so long as your monthly rental payment is on time and in full. We reserve the right to use any remedy deemed necessary (including lawsuit) to take possession of unreturned rental instruments and to collect all past due rental fees, late fees, and legal fees, collection costs, and losses due to instruments not covered by the maintenance agreement. Possession of an instrument owned by us constitutes acceptance of the terms of this contract.

Pre-ordering a Rental: Upfront payment of the first three month’s rent is accepted in good faith, and the contract begins on the day the instrument is picked up or delivered to the renter. We know that life throws curve balls and plans change! This charge is refundable up until the date the instrument`s contract is set to begin (ie. the first day of school).
Maintenance Plan Details
The renter will be responsible for our instrument, including theft or damage (reasonable wear excepted), until the instrument is returned. The renter is required to pay for a monthly maintenance agreement. The maintenance agreement covers broken bridges and bows, and general upkeep of the instrument. Major damage to the body of the instrument, including but not limited to broken necks, and stolen instruments may result in a $100 deductible fee for violin, $250 for cello, and $300 for bass. Claims for stolen instruments must include a police report. The maintenance agreement is not in effect during air or overseas travel, except with specific authorization. The maintenance agreement will not cover: Theft from an automobile, heat damage, lost or intentionally damaged instruments; damage incurred during shipping; or shipping costs. We must perform or authorize all repairs. We reserve the right to charge the cost of repair or replacement to any credit card on file, should damage or loss not be covered by the maintenance agreement. Renters whose instruments are stolen or badly damaged will lose any equity accrued. Should maintenance or repair be required on an instrument, bow, and/or case, the renter is responsible to bring the instrument, bow, and/or case to Sam`s Strings during regular business hours. Sam`s Strings may also be able to provide other pickup and delivery options as an added convenience.

Maintenance Fees: Violin/Viola: $6 per month Cello: $7 per month Bass: $10 per month
Rental Credit
Equity/Purchase Plan: This is not a “rent to own” contract. The instrument being rented is NOT for sale. However, if the renter wishes to purchase any of our many instruments for sale, we offer the following: 100% of your rental fees can be applied up to half the list price of any instrument we have in stock (violin starting from $499, violas from $549, cellos from 1399 and basses $1599 and up )- ie: 2 years of violin rentals at $19 X 24= $456; Purchase a violin at $899, and $449.50 can be applied to the purchase). Equity is not transferable to other instruments or accessories (ie. cello to violin). The maintenance and tax payments are not included. Instrument equity may not be combined with other rentals’ equity. Equity expires when the instrument is returned. *Renters whose instruments are lost or badly damaged will lose any equity accrued up to the purchase price of the instrument.
Terms and Conditions
By E-Signing, I understand and agree to the terms, conditions, definitions, rates, and costs as explained on the Sam`s Strings Rental Form and agree to have my credit card charged for the amount selected above.

E-Signature*
Last 4 Digits of the Credit Card to be Charged* XXXX
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