I
Bowflex ®TreadClimber ®Warranty Registration Card
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PLEASE PRINT CLEARLY - THANK YOU
1. _ Mr. 2. _ Mrs. 3. E Ms. 4. _ Miss Customer ID from Invoice l
Name:
Address:
City: I State: [_
Phone number: I- I
E-Mail address:
Is this your primary address? E Yes _ No
Place of purchase:
Date of purchase:
Purchaser date of birth:
Gender: E Male _ Female
Marital status: _ Married E 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 E No
Which bestdescribes your familyincome:
Under$15,000 _ $25,000- $34,999
$15,000 - $24,999 _ $35,000 - $49,999
Whatothertypes ofexercise equipment do you own?
$50,000 - $74,999
$75,000 - $99,999
Apt. #:1
Zip:l
$100,000 - $149,999
OverS150,000
Did you receive this item as a gift? E Yes
Name of original purchaser:
Original purchaser customer ID number: I
E No
Thanks for filling out this questionnaire. Your answers are important to us. Please check here u if you would prefer
not to obtain information on new and interesting opportunities from other exciting companies.
® 2005. Nautilus, Inc. All Rights Reserved. Bowflex and TreadClimber are registered trademarks of Nautilus, Inc.
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