Order form for cheque payments only.
To pay by Credit/Debit card, please telephone your order to:
01254 243727
Please complete and print the Order form, then post it to the address
below together with your cheque made payable to:
Address:
43, Bradyll Court,
Brockhall Village,
Old Langho,
Blackburn,
Lancashire,
BB6 8AS
United Kingdom
Where did you see our Advertisement?
Title
Full name
Address 1
Address 2
Address 3
Address 4
Address 5
Postcode
Telephone
Gyms required £179 per gym
£
Cases required £20 per case
£
Power Pads required £10 per pair £
Postage
& Packaging cost
£
Total Cost £
Date of Order