Mr.
2. Mrs.
3. Ms.
4. Miss
Name:
Address:
Apt. #:
City:
State:
Zip:
Phone number:
( )
- x
E-Mail address:
Is this your primary address? Yes No
Place of purchase:
Date of purchase:
M M D D Y Y
Purchaser date of birth:
M M D D Y Y
Gender: Male Female
Marital status:
Married Single
Including yourself, total number of people living in your household: (Examples: 01, 02, 03 …)
Would you like to receive additional information on healthy lifestyle products? Yes No
Which best describes your family income:
Under $15,000
$25,000 – $34,999
$50,000 – $74,999
$100,000 – $149,999
$15,000 – $24,999
$35,000 – $49,999
$75,000 – $99,999
Over $150,000
What other types of exercise equipment do you own?
Did you receive this item as a gift? Yes No
Name of original purchaser:
© 2004, Schwinn Fitness 1400 NE 136th Ave. Vancouver, WA 98684. Schwinn and the Schwinn logos are registered trademarks of Schwinn Fitness. 17238 Rev AA (03/04)
Nautilus Inc., All Rights Reserved. Schwinn Force is a Trademark of Nautilus Inc. Schwinn and the Schwinn Quality Seal are Registered Trademarks.
Schwinn
®
Force
TM
Home Gym Warranty Registration Card
IMPORTANT! MAIL WITHIN 30 DAYS OF PURCHASE
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Содержание Fitness Force
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