Instrument Rental Form

Instrument Rental Form
Name of Person Responsible for Payment*

First NameLast Name
Address - if different than billing address (see below)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email - please enter twice*

Confirmation Emailexample@example.com
Is your residential and billing address the same?

YesNo, I have a different billing address
Please provide your residential address below:
Residential address line 1*
Residential address line 2
Town*
State*
Zip code*
Contract number
Start date

MonthDayYear
Date
Issue date (if different than start date)

MonthDayYear
Date
Player name*

First NameLast Name
Instrument*
Instrument size (if known)
Instrument Number
Player height (in ft & in preferred)*
For sizing purposes
Length of Arm in inches - from base of neck to center of palm (arm extended from shoulder)
If you indicated a size above, enter "NA" here
Grade*
Strings Program*
Please select your school program
Are you experience any financial hardship at this time that would make renting an instrument difficult?

Yes
You may not need to rent.

Many string programs have a limited supply of instruments for parents/students in your position. Before starting a rental, we recommend reaching out to your string teacher about your situation in case they may be able to assist you with an instrument.

If you do not have contact information for your teacher, please contact us at info@beekmanviolin.com. We can help connect you and ensure that your child has an instrument to play.
IMPORTANT INFO FOR SOUTH KINGSTOWN ELEMENTARY RENTERS:

We have two instrument pick-up options for South Kingstown elementary renters:

1) To make an appointment during regular shop hours, follow the link on the thank you page after you've submitted your form. Regular shop hours are as follows:
- Wed-Fri 12-5:30pm
- Sat 10am-3pm
2) We are offering special extended hours for rental pick-ups only on the following days:
- Thursday 9/18/25 - 5:30-7pm
- Friday 9/19/25 - 5:30-7pm
We have three instrument pick-up options for North Kingstown renters. Please select your pick-up preference below:*

During regular store hours: Wed-Fri 12-5:30pm, Sat 10am-3pmDuring special extended store hours: Thurs 9/18 or Fri 9/19 5:30-7pm.Violin/Viola ONLY: deliver my child's violin/viola to their school on the morning of Friday 9/19
To make an appointment during special extended hours, select an appointment from the calendar below. Select the date on the calendar, and then choose a time slot from the available options.
To make your instrument pick-up appointment during store hours, just follow the link to our booking site on the Thank You page after submitting this form.
Special Extended Hours Appointments
Please choose your instrument pick-up night appointment below:*
We will send automated billing reminders and other important updates about your account via email. Would you also like to receive notifications via text?*

Yes (message and data rates may apply)No, please use email only for automated account notices
From time to time, we may send other communications. We promise to respect your inbox(es) and will keep these to a minimum. You can select/deselect your preferences for these communications below:

Private lessons and class offeringsSales and discountsNew instruments and other productsCommunity events
Long-term indicator
Purchases and Payment information

PAYMENT WILL BE AUTHORIZED ONLY. Once instrument is issued payment will be processed. IMPORTANT- the BILLING ADDRESS must MATCH address on file with bank or YOUR REGISTRATION WILL NOT BE SUCCESSFUL.

Please select your instrument rental and accessories below:*

Signature*
IMPORTANT:

CREDIT CARD BILLING ADDRESS must match what is on file with BANK issuing card before you SUBMIT- Form will NOT PROCESS if there is a MISMATCH.
Should be Empty:

Instrument Rental Form

Purchases and Payment information

IMPORTANT: