User Instruction Manual V1.01 (Rev.998 2010)
52
Warranty Registration Form
NOTE: To register and activate your warranty, this form must be completed and
returned to the manufacturer directly with a copy of your invoice or bill of sale.
Change of ownership must be notified to Dermaray in writing. Warranty may also be
submitted online
www.dermaray.com/registration.htm
Customer Information;
Full name:
____________________________________________
Address:
____________________________________________
____________________________________________
Town/City:
____________________________________________
Zip Code:
__________________ Country: _________________
Phone:
____________________________________________
Mobile:
____________________________________________
Email:
____________________________________________
Why you chose this product: __________________________________
____________________________________________
Would you like to be informed of new products, updates and other
important information by email?
Place of Purchase Information;
Date of purchase:
____ /____ /_____
Supplier’s name:
___________________________________
Supplier’s address:
___________________________________
___________________________________
Supplier’s phone:
___________________________________
Suppliers web page:
___________________________________
Purchase price:
___________________________________
