CREDIT CARD PAYMENT
PAY US VIA PAYPAL.


                 
ONLINE AGREEMENT TERMS AND CONDITION
AND PAYMENT FORM

**YOU MUST HAVE AN APPROVED INVOICE BEFORE USING THIS FORM**

                    THIS FORM IS MANDATORY FOR ALL RENTAL AND SERVICES AGREEMENTS NO MATTER ON FORM OF PAYMENT
                    THIS FORM IS REQUIRED ON RENTAL AND SERVICE AGREEMENTS TO PAY FOR LOST OR DAMAGED EQUIPMENT, AS WELL AS
                    SERVICES PROVIDE BY CONFETTI AND FOG FX INC. 
I AUTHORIZE CONFETTI & FOG FX TO CHARGE THE FOLLOWING
                   CREDIT CARD  FOR THE TOTAL AMOUNT AGREED ON.
ALL FIELDS ON THIS FORM ARE REQUIRED. 
                  
                   PLEASE DO NOT LEAVE ANY FIELDS BLANK! ALL FIELDS ARE REQUIRED
                   

F                 RENTAL AGREEMENT TERMS AND CONDITIONS
             
                   SERVICE AGREEMENT TERMS AND CONDITIONS


CONTRACT AND BILLING INFORMATION
QUOTE OR INVOICE NUMBER*
FIRST & LAST NAME*
BILLING ADDRESS*
APT OR SUITE #
CITY*
ZIP CODE*
(5 digits)
STATE*
PHONE NUMBER*
EMAIL ADDRESS*
EVENT NAME*
VENUE NAME & ADDRESS*
EVENT DATE*
EVENT START & END TIME*
CREDIT CARD INFORMATION
NAME ON CARD*
CREDIT CARD TYPE*
PAYMENT AMOUNT*
(USD)
CREDIT CARD NUMBER*
EXPIRATION DATE (MM/YYYY)*

CARD VERIFICATION NUMBER*

DRIVER'S LICENSE STATE & NUMBER*

FOR RENTALS ONLY
 RENTAL RATE*
DAILY  WEEKLY  MONTHLY
RENTAL PICKUP DATE*:
RENTAL RETURN DATE*:
 DID YOU REVIEW & ACCEPT THE FOLLOWING
1. WAIVER OF TECHNICIAN
2. RELEASE OF LIABILITY
3. HOLD HARMLESS AGREEMENT
4. EQUIPMENT & EFFECTS POLICY
YES  NO
NOTES
I HAVE REVIEWED AND UNDERSTAND ALL AGREEMENTS TERMS AND CONDITIONS AND AUTHORIZE CONFETTI & FOG FX SPECIAL EFFECTS COMPANY TO CHARGE THE FOLLOWING CREDIT CARD FOR THE AMOUNT STATED ON THE APPROVED INVOICE ALL CUSTOMERS ARE REQUIRED TO PAY FOR LOST, DAMAGED, LATE RETURNS, AND NON-RETURNED EQUIPMENT. I AUTHORIZE CONFETTI & FOG FX INC. TO CHARGE THE FOLLOWING CREDIT CARD ON FILE IN THE EVENT(S) LISTED ABOVE.