PRODUCT PURCHASED:

MODEL NUMBER:

OWNER'S NAME:

STREET ADDRESS:

CITY:

STATE:

ZIP CODE:

EMAIL ADDRESS:

PHONE:

OWNERS AGE (OPTIONAL):

SEX (OPTIONAL):

DATE PURCHASED:

PURCHASED FROM:

HOW DID YOU HEAR ABOUT US?

OTHER, PLEASE EXPLAIN:

ARE YOU A:

TREESTAND PREFERENCE:

WILL YOU USE THE SAFETY HARNESS PROVIDED OR A DIFFERENT BRAND?

IF DIFFERENT, WHICH BRAND & MODEL?