Parent Name *

First Name

Last Name

Student Name *

First Name

Last Name

Phone

(###)

###

####

Loaner Required *

We will do our best to accommodate!

Yes

No

Parent/Guardian Name *

First Name

Last Name

Phone (Best # to Reach You) *

Best # to Reach You

(###)

###

####

Work Phone

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Instrument Choice *

Percussion Kit: Starting at $15: includes rolling case, practice pad, drumsticks, bell mallets, sturdy stand, and music rack. Two kit styles to choose from. Our team will discuss styles with you upon reservation.

Clarinet: $23/month: includes case, mouthpiece, mouthpiece cap, ligature, reed, swab, and cork grease.

Flute: $23/month: includes case and cleaning rod.

Trombone: $23/month: includes case, mouthpiece, and slide lubricant.

Trumpet: $23/month: includes case, mouthpiece, and valve oil.

Alto Sax: $40/month: includes case, mouthpiece, mouthpiece cap, ligature, neck strap, reed, swab, and cork grease.

Oboe: $40/month: includes case, reed, swab, and cork grease.

Baritone (Euphonium): $48/month: includes case, mouthpiece, and valve oil.

French Horn: $48/month: includes case, mouthpiece, and rotary valve oil.

Tenor Sax: $48/month: includes case, mouthpiece, mouthpiece cap, neck strap, reed, cork grease, and swab.

Violin: $23/month: includes case, quality bow, and rosin.

Viola: $23/month: includes case, quality bow, and rosin.

Cello $36/month: includes padded bag, quality bow, rosin, and endpin rest.

Upright (Double) Bass $68/month: includes padded bag, quality bow, rosin, and endpin rest.

Method Book Needed?

Yes

No

Music Stand Needed?

Yes

No

Student Name (First, Last) *

First Name

Last Name

Parent Name *

First Name

Last Name

Student Name *

First Name

Last Name

Phone

(###)

###

####

Teacher

First Name

Last Name

Pick Up Location *

School

Home

I will drop off at Knapton

Other

Date Finished with Rental

MM

DD

YYYY