Order – Wireless Microphone Rentals

Company // Organization Name *

DIGITAL Lo Profile (tan) headsets @ $115/ea. per week

DIGITAL Lo Profile Theatrical Wig Lavaliere @ $115/ea. per week

DIGITAL Standard Lavaliere @ $85/ea. per week (copy)

Lo Profile (tan) headsets @ $95/ea. per week

Lo Profile Theatrical Wig Lavalier mic @ $95/ea. per week

Standard Lavalieres @ $65/ea. per week

Standard Headsets @ $65/ea. per week

Handheld Microphone @ $65/ea. per week

Wireless In-Ear Monitor @ $95/ea. per week

Antenna Distrobution System @ $200 per 8ch.

AA Batteries - 20 for $11.80

Date Needed to Arrive? *

Date you will send back? *

Contact Name *

First

Last

Email *

Business Shipping Address *

Address Line 1

Address Line 2

City

State

Zip Code

Billing Address is Different than Shipping Address

Add Billing Address

Phone *

Email Address (used for Tracking and Account info) *

We do not share your information!

Confirm Email Address *

Check here if you are sending a check. Must be received at least 3 days prior to shipment

We are sending a check

Credit card is still required for security purposes.

Credit Card Number *

xxxx-xxxx-xxxx-xxxx (no Discover) | THIS IS REQUIRED TO PLACE AN ORDER

Card Expiration Date *

MM / YYYY

CVV2 (security code) *

Code on back of card

Order/Quote Number (If Available)

Comment or Message

By checking the box below, I agree that I have read and agree to the terms and conditions of the rental contract attached below. I also understand and agree that I am fully responsible for the equipment while it is in my possession. *

I agree

The wireless microphones are very delicate and capable of breaking or becoming damaged if mistreated. If the microphones are returned deformed, cut, torn or damaged from misuse, you will be charged for the replacement, necessary repairs or cleaning fees. *

I accept these terms

Signature *

Name of Signee *

Message