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Title:
Surname:
Address Line One
Address Line Two
Town/City
Postal Code
Country
Daytime Phone No.
Mobile Phone No.
E-mail Address:
Confirm E-mail Address:
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for Serial Number and Product Code Help
Product Code:
Serial Number:
Retailer:
Date of Purchase:
Retailer Order No. (if applicable)
Member/Account No.
Where is the Machine Located?
Living Room
Dining Room
Bedroom
Kitchen
Utility Room
Conservatory
Home Gym
Cellar
Attic
Garage
Other
How often do you use the machine?
Once a Month
Twice a Month
Three Times a Month
Once a Week
Twice a Week
Three Times a Week
Four Times a Week
Five Times a Week
Six Times a Week
Daily
Never/Rarely
How many people use the machine?
Just Myself
Two People
Three People
Four People
Five People
Six or More People
Comments:
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© 2008 Icon Health & Fitness (UK) Ltd
