Bowflex Revolution® 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: | ( |
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State:
Apt. #:
Zip:
Is this your primary address? Yes |
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Date of purchase: |
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Purchaser date of birth:
M M
D D
Y Y
Gender: Male | Female |
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Marital status: | Married | Single |
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Including yourself, total number of people living in your household: (Examples: 01, 02, 03 …) |
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Would you like to receive additional information on healthy lifestyle products? Yes | No | ||||||
Which best describes your family income: (US dollar figures) |
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Under $15,000 |
| $25,000 – $34,999 | $50,000 – $74,999 |
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| $100,000 – $149,999 | |
$15,000 – $24,999 |
| $35,000 – $49,999 | $75,000 – $99,999 |
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| 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:
Thanks 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.
©2005. Nautilus, Inc. All rights reserved. Nautilus, Bowflex, the Bowflex logo, Bowflex Revolution and Power Rod are either registered trademarks or trademarks of Nautilus, Inc. All other trademarks are owned by their respective companies.
Nautilus, Inc., World Headquarters, 16400 SE Nautilus Drive, Vancouver, WA 98683
