Your Name:  

Address: City: State: Zip:

Email Address:

Date you will be arriving in Modesto for final fitting? (Approx. 1 week before wedding/event:)

Day Phone #:   Home     Work     Cell

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Brides Name:

Wedding Date:  

Please measure wearing your SHOES that will be worn with the dress.
If you are renting shoes, complete the shoes OFF, we will calculate the heel height for you.
Stand Up Straight - Feet Together.     :-)

Bust: "    Waist: "   Hips: "
From bra strap on top of shoulder, over bust to floor with shoes ON: "
(2 piece dress only) From waist to floor with shoes ON: "

From bra strap on top of shoulder, over bust to floor with shoes OFF: "
(2 piece dress only) From waist to floor with shoes OFF: "

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Rental Dress Style #($79 Rental Fee):

Dress Color:

Do you want to rent a matching shawl? ($10 rental fee): Choose One YES NO

Rental Shoe Style ($19 Rental Fee):

Shoe Size:

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Disclosure: 

(Please measure to the best of your ability.)

~ Rent A Bridal Gown has not taken the measurements. If there are alterations to be completed at time of fitting, beyond $15, you are responsible for the cost of the additional alterations.  

~ If there are alterations to be completed at your fitting under $15, Rent A Bridal Gown will perform without charge.

~ The cost of the alterations depends on the new sizing.

~ Alterations that Rent A Bridal Gown will not perform for free if measurements are not correct:  
~~Dress Hem's ~ Cost = $35.

~ Total of dress rental only is $89.83
~ Shawl rental add $10.74
~ Shoe rental add $20.40
~ Strapless Bra rental add $26.84 

~ Payment can be made with Visa, Mastercard, Discover & (American Express thru Paypal.)

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(please initial) ~ IF NOT RETURNED BY RETURN DATE, DEPOSIT IS SURRENDERED.
~ All items must be received by the agreed RETURN DATE and in the condition in which they were rented.
~ If not returned by the return time on rental agreement, $15 late fee per item is charged to security credit card.
~ If not returned due to any reason, the listed retail value minus rental fees will be due, and appropriate action will be taken.
~ Any rental fees paid are non-refundable, but can be transferred to another gown of your choice.
~ Alterations are performed exclusively at: Sewing & More, 903 W. Roseburg Ave. Modesto 209-523-7189.
~ ALL rental fees must be paid in full prior to pick-up date.
~ If from out of town, cash or credit card only for payment of items.
~ Cleaning is included in the rental fee.  Please DO NOT have any items cleaned.
~ Business hours: Monday-Friday: 12:30pm-6pm, Saturday. 11am-4pm.
~ If this rental or a portion of this rental is cancelled for any reason, any amount paid is NON-refundable to cover cancellation fees..
~ 

I hereby understand all of the above terms and conditions.  I will be responsible for all items listed above.

 Please type in your name here.
This is your signature for renting from Rent A Bridal Gown.