signup for our rental program
To take place in our rental program, simply fill out the form below. You can choose to be billed monthly or annually. If you choose to be billed annually, we will give you one month free. We also ask for an estimate of how many rentals you would like at a time. You can always change this number later via the your account section of our site. Remember, for each rental you receive, you will be asked to mail a rental to another user.

account info
If you already have an account with BSR Media, please use this form to signup for our rental program.
Username:
Password: (4-10 characters)
Re-type Password:
First Name:
Last Name:
E-mail:
Day Phone #:
Night Phone #:
Address:
Address Line 2:
City:
State:
Zip Code:
Country: United States
Sign me up for the BSR Media newsletter. (HTML or Text)
credit card info
Card Number:
Card Type:
Expiration Date:
account options
Bill Monthly $4.95
Bill Annually $54.45 - Best deal, get 12 months of rentals for the price of 11!
Preferred number of rentals at a time: