Clarinet Rental Form

Price for rental is $5 per week, invoiced per term.

Title *MrMrsMiss

First Name(s) *

Last Name(s) *

Address *

Mobile Phone *

Home Phone

Form of Identification *Drivers Licence

Details required for identification purposes

Drivers Licence Number *

Please attach a copy of identification below the form

Driver’s Licence Version Number *

(Line 5b)

Date of Birth Shown on Licence *

(DD/MM/YYYY)

Instrument *Clarinet

To be returned after hire period

Accessories Included (No Extra Charge) *

• Case
• Case Strap
• Cloth
• Reed
• Reed Protector
• Lubricant

To be returned after rental period

Rental Start Date *

(DD/MM/YYYY)

Rental Period (e.g. 10 weeks) *

$5 per week

I agree to the Aeon Musique Hire Terms and Conditions *Yes

Comments/Queries

Name

Submit

Please upload a form of photo identification below, and press “Upload File” before submitting your rental application.

Upload files

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*Please refer to our Instrument Rental Terms and Conditions.