Rental Registration

Thank you for choosing to rent with Eleven04. If this is your first time renting with us, this registration form is what you need to fill out. You only need to fill out this form ONCE to set up a profile with us. If you are a retuning renter, please send us your gear list using the Quick Quote or Shopping Cart.

It normally takes about 1-2 business days for us to complete the registration process.
About You
First & Last Name*
Your Role on Set
Other role*
Upload a front Image of your ID*

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Upload a Back Image of your ID*

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Phone number?*
Please enter a valid phone number.
Email Address*
example@example.com
Preferred Contact Method*

CallTextEmail
Reel/Website (this cannot be from a social media site) *
Instagram handle (if any)
IMDB Link (if any)
Registration Type
- You must choose a Registration Type in order to proceed
- Individual: film crew or freelancer who rents under their own name
- Company/Organization: production that rents under a company/organization's name
- Student: currently enrolled in any college or university
Registration Type*
Point of Contact*

I am always the main point of contactThe point of contact changes on every job
Company/Organization Name*

Organization NameEntity Type(LLC, LLP, INC, School/Uni, 501(c)(3)(NFP
FEIN Number*
If the company/organization is a foreign entity that doesn't have a FEIN number, please type in
Company/Organization Phone Number*
Please enter a valid phone number.
Company/Organization Website (this cannot be social media site)*
Company/Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School (College/University/Institute)*
School Year*
Student ID or Class Schedule*

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Film/Video Industry References
- For INDIVIDUAL and COMPANY/ORGANIZATION, please provide (2) references. (1) reference must be either a rental house or retail vendor you've worked with in the past and the second reference can be any individual or production company you've worked in the past within the film/vide/theater industry.
- For STUDENT, please provide (2) professors/mentors as your references.
Reference 1 Full Name*
Reference 1 Role (Set Role, Company, etc.)*
Reference 1 Phone Number*
Please enter a valid phone number.
Reference 1 Email Address*
example@example.com
Reference 2 Full Name*
Reference 2 Role (Set Role, Company, etc.)*
Reference 2 Phone Number*
Please enter a valid phone number.
Reference 2 Email Address*
example@example.com
How did you find out about us?*
Other?
Payment Information
We require a credit card on file for ALL rentals regardless of the desired method of payment.
Front*

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Back*

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Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Tax Exemption Status
Are you Tax Exempt? (Tax Exemption document must be submitted)

YesNo
Please upload your tax exemption document*

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Additional Information
Any special notes about your registration for us?
Insurance Requirements
By submitting this Registration, we will also review if you are insurance exempt, this DOES NOT require extra step. Insurance Exempt gives you the ability to rent without providing a COI or deposit for orders with a replacement value less than $10,000. Insurance Exemption is given based on the registree's experience. Reviewing any registration takes 1-2 business days, for an urgent order, please provide a valid COI or deposit for the rental.
Terms and Conditions
In order to rent with us, you must agree to the following terms and conditions.

1. A submission of Registration and Insurance Exempt Application does not guarantee an approval. Eleven04 Productions, LLC reserves the right to refuse service as it chooses.

2. A submission of this form does not guarantee the availability of the equipment.

3. The applicant or the preparer of the applicant acknowledges that to their best knowledge, the information they filled out is accurate and true. Eleven04 Productions, LLC is not responsible for any damage or legal obligation that is caused or related to the incorrect or inaccurate information on this form.

4. You will be enrolled in our monthly newsletter. You are free to unsubscribe at anytime.

5. The reviewing process of the Registration takes 1-2 business days.
You must accept the terms in order to rent with us. Do you accept the terms?*

I Accept
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