P
lease complete the following form for your own records.
Wheelchair serial number
Model of wheelchair
Name of the sales representative
Name of the dealership
Telephone number of the dealership
Address of the dealership
Purchase Date
Colours, Colours logo, RazorBlade, Boing!, Saber, Eclipse, Spazz, RazorBlade
Jr, Chump, Krypto, ShockBlade, and Little Dipper are trademarks of Colours
in Motion.
©
2010 Colours in Motion. All rights reserved. Printed in the USA.
WARRANTY CARD
This card must be returned to Colours in order to activate the warranty for your Colours wheelchair.
Wheelchair serial number
Model of wheelchair
Name of the dealership Purchase Date
Name of owner
Address
City State Zip Country
Phone Fax
E-mail
How many Colours chairs do you own (including this one)?
Disability Years disabled
Age Sex Occupation
What are your favorite magazines?
Would you like to receive Coloured Paper (Colours’
newsletter) to stay up-to-date with the latest devel-
opment at Colours? J Yes J No
By providing the above signature, I acknowledge the
terms and conditions of Colours wheelchair warranty.
X
Signature Date
'2010 Colours Wheelchair
c o l o u r s w h e e l c h a i r . c o m
'2010 Colours Wheelchair
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