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Victoria at the southeast tip of Vancouver Island is by far the largest concentration of people on the island. The east side facing the Strait of Georgia and mainland Canada is much more developed than the rugged west coast. The west coast has intermittent access via roads and has long stretches of shoreline with no roads nearby, while the island's east side has highways (1 and 19A) that generally stay close to the coast from Victoria up to Campbell River 260+ km to the northwest.
Welcome to Vancouver Island Surfskiing
Are there rentals on the island? Closest maybe in Vancouver, BC
You have to use ferries for car travel to and from Vancouver Island. BC Ferries Website
As far as getting a reservation for your preferred ferry - keep checking the BC Ferries reservation page as people often cancel their reservation and BCF adds more reservations 3-5 days before a sailing (so keep checking!).
Getting to Victoria
Getting to Nanaimo (these pages have links to the return schedules)