Bowflex Blaze Owners Manual - Page 55

Bowflex® Blaze™ Home Gym Warranty Registration Card IMPORTANT! MAIL WITHIN 30 DAYS OF PURCHASE PLEASE PRINT CLEARLY - THANK YOU Mr. 2. Mrs. 3. Ms. 4. Miss Customer ID from Invoice Name: Address: Apt. #: City: Phone number: ( ) - EXT. E-Mail address: State: Zip: Is this your primary address? Yes No Place of purchase: Date of purchase: M M D D 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: (US dollar figures) Under $15,000 $25,000 - $34,999 $50,000 - $74,999 $15,000 - $24,999 $35,000 - $49,999 $75,000 - $99,999 $100,000 - $149,999 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: Original purchaser customer ID number: Thanks for filling out this questionnaire. Your answers are important to us. Please check here if you would prefer not to obtain information on new and interesting opportunities from other exciting companies. © 2006, Nautilus Inc. All Rights Reserved. 16400 SE Nautilus Dr., Vancouver, Washington, USA 98683. Bowflex, Blaze, Power Rod and the Bowflex and Nautilus logos are either registered trademarks or trademarks of Nautilus Inc.