FITNESS SPORT No 1 year 2003

APPLICATION FORM If you are interested in the STRENFLEX™ fitness sport, please reply with the following form. Choose your products:  Strenflex Championship regulations

Choose your membership (optional):  I’am already Strenflex Member nr.

€ 20.-

SUBSCRIBE

 English  German  Russian

 no membership

 Strenflex T-Shirt, white, size L, € 15.-, members

€ 13.-

 Strenflex Membership, valid 1 year

€ 60.-

 Strenflex Sticker, size 170x46mm

€ 3.-

 Strenflex Promo Gym, 1 year, only gym owners € 520.- Choose your instruction level:  I already completed the Basic-Workshop

Total €

Choose your payment mode:  via Bank in € , Bank account: UBS 267-824781.61N UBS AG Zurich Switzerland

 Basic-Workshop, 1/2 day, € 150.-, members

€ 104.-

 Advanced-Workshop, 1 day, € 225.-, members € 150.-

 Credit Card

 EuroCard  MasterCard  Visa

 Judge-Workshop, 2 days, members only

€ 200.-

card number

expire date

 Training day, 1/2 day, € 140.-, members

€ 70.-

Give us your personal data:

Surname

First name

Age

Name of your gym

Street

ZIP code

City

State / Province

Country

Email address

We work for the future and for the benefit of our health!

Phone

Fax

Send this form to: STRENFLEX - Grindelstrasse 5 - CH-8304 Wallisellen Fax +41 1 883 73 92

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STRENFLEX fitness sport 11