Rental Order Form

If used for in-store pickup, the credit card must be brought into the store for release.

We cannot ship to a post office box.

Failure to wholly complete this form renders this order null and void.

Debit cards cannot be accepted.

Please note that all prices and policies subject to change without notice.

Due to customs complications and prohibitive shipping costs, we do not ship rental items internationally.

Billing Information

Name:
Organization Name: (please do not use initials; you know what they stand for but we may not)
Billing Address and Suite: (note that we cannot ship to a post office box)
City, State and Zip:
Residential Address?	Circle One: YES NO
Commercial Address?	Circle One: YES NO
Billing Phone Number:
Home Phone Number:
Office Phone Number:
Office Fax Number:
Mobile Phone Number:
Email Address:

Shipping Information

[ ] Check here is the same as Billing Information

Name:
Organization Name: (please do not use initials; you know what they stand for but we may not)
Shipping Address and Suite: (note that we cannot ship to a post office box)
City, State and Zip:
Residential Address?	Circle One: YES NO
Commercial Address?	Circle One: YES NO
Shipping Phone Number:
Home Phone Number:
Office Phone Number:
Office Fax Number:
Mobile Phone Number:
Email Address:

Costumes To Be Rented

Please remember to include the complete measurements of the people wearing the costumes.

Code and Description	2-Night Rental Rate
	$









Rental subtotal:	$

8% Chicago Transaction Tax for rentals picked up, delivered or shipped within Chicago: For tax exemption, please include a copy of the Tax Exempt Letter issued to you by the Department of Revenue of the State of Illinois in Springfield.	$

Date Needed:
Return Date:

Shipping: We can arrange for delivery or pick up of your order locally by outside courier for a modest charge. We ship throughout the United States. Please note that shipments to Hawaii and Alaska cannot be sent by GROUND service. We do not ship rental orders internationally. Shipping cost is determined by actual box size, weight of the costumes, destination and type of service plus a $10 handling box charge. If the order is not received two weeks prior to our ship out date, we reserve the right to use whatever method necessary to get the shipment to you by your required date. Please circle the type of service you prefer: Ground 3rd Day 2nd Day Next Day Air

For local delivery, please call for exact price:	$

Total:	$

Credit Card Information

Circle Credit Card to be billed:
(debit cards cannot be accepted):

Name On Credit Card:
Credit Card Number:
Expiration Date:
Card 3-digit CSC Number:
Issuing Bank:
Signature:

Costumes will be altered per measurement forms. Alterations are done to the measurements that you provide. We cannot be held responsible if the measurements are incorrect and, as a result, the costumes do not fit. Costumes not claimed on the date scheduled are considered canceled. In the event of cancellation, the signer below is liable to the extent to which work has been progressed and in no event shall this be less than 50% of the value of the order. If the costume is ready at the time of cancellation, the charge is the full value of the order. The signer’s credit card will be pre-authorized for $250-$500 for each costume as a security deposit. The pre-authorization will be cancelled upon the prompt return of the undamaged costume. The security deposit in no way reflects the actual value of the costume. The above listed items are to be returned (or shipped prepaid via Federal Express, UPS or local courier) no later than the above RETURN DATE. Incurred late fees (amounting to 20% of this contract’s total per day late), the replacement value of missing items and repair costs of damaged items will be charged to the signer’s credit card. Debit cards cannot be accepted.

Date:____________________ Signature:______________________________________________

Print, complete and fax (or mail) this form to:

Broadway Costumes™, Inc
Rental Department
1100 West Cermak Road · Second Floor
Chicago · Illinois · 60608 · USA
312-829-6400 · 800-397-3316 · 312-829-8621 (fax)