Order – Wireless Microphone Rentals

Company // Organization Name *

1. Digital Wireless Headset / Wig Mic @ $125/ea. per week

2. Digital Wireless Lavaliere @ $85/ea. per week

3. Digital Wireless Handheld @ $85/ea. per week

4. Digital Wireless Corporate Headset @ $85/ea. per week

5. G3/G4 Wireless Theatrical Headset / Wig @ $95/ea. per week

6. G3/G4 Wireless Lavaliere Mic @ $65/ea. per week

7. G3/G4 Wireless Corporate Headset @ $65/ea. per week

8. G3/G4 Wireless Handheld Microphone @ $65/ea. per week

Wireless In-Ear Monitor $85/ea. per Week

Sennheiser Wireless Antenna Combiner with Directional Antennas

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

You agree to not use makeup, tape or any other substance on the microphone cable, capsule, frame or connector. Any makeup that is used and stains the microphone will be billed to replace the entire microphone. Any tape, tape residue, makeup or products that require Beamworks to do more than a simple cleaning process will be charged a cleaning fee * *

I accept these terms

Signature *

Name of Signee *

Comment