Last Name: First Name: Middle Name:
Street Address:
P. O. Box: City: State:
E-mail Address: Home Phone: Cell Phone:

Fitness Partner Please enter preferred date and time
Knee Sleeves 1 2 3 4 other Enter amount and sizes
Muscle Roller Stick 1 2 3 4 other Enter amount and color
Body tight shirts 1 2 3 4 other Enter amount and sizes
Socks 1 2 3 4 other Enter amount amd color
Screen Printing 1 2 3 4 other Enter amount, sizes, and description
Team Rings 1 2 3 4 other Enter amount and description
Head Phones 1 2 3 4 other Enter amount and color
Cell Phones 1 2 3 4 other Enter amount and specifications
Mini Speakers 1 2 3 4 other Enter amount and color

Cash Cheque

Please Note: Cheques take 7 working days to clear.