Bowflex Ultimate Assembly and Owners Manual - Page 107

Bowflex® Ultimate™ 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: City: Phone number: - E-Mail address: Is this your primary address? ■ Yes ■ No Place of purchase: State: Apt. #: Zip: Date of purchase: M M D D Purchaser date of birth: M M D D Gender: ■ Male ■ Female Y Y Y Y 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 ■ $50,000 - $74,999 ■ $25,000 - $34,999 ■ $100,000 - $149,999 ■ $15,000 - $24,999 ■ $35,000 - $44,999 ■ $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: Original purchaser customer ID number: Thank you 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.