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Thank You For Your Purchase

In order to help us serve you better, please fill out the registration form below. Of course, Diamondback Fitness does NOT sell your registration information to third parties and keeps all information absolutely confidential.

 

You are well equipped for fitness success!

  * indicates a required field
Date of purchase: * / /
What type of machine
did you purchase? 		*
Model number: *
Product serial number: *
Purchased from
(dealer name): 		*
Dealer's State:
(do not use outside the US and Canada) 		 
Price paid:
(excluding sales tax) 		 
Enviroment: *
Reason Purchased:  
 
Title:  
  • Mr.
  • Mrs.
  • Ms.
  • Dr.
First name: *
Last name: *
Gender: *
  • Male
  • Female
Email address: *
Address 1: *
Address 2:  
Address 3:  
City: *
State:
(do not use for outside of US or Canada) 		 
Zip/Postal code: *
Country: *
Daytime telephone:   () -
Evening telephone:   () -
Your date of birth:   / /
Marital status:  
  • Married
  • Single
Annual Income:  
Occupation:
(check all that apply) 		 
YouSpouse
Housewife
Professional/Technical
Upper Management/Executive
Middle Management
Sales/Marketing
Clerical/Service Worker
Tradesman/Machine Operator/Laborer
Student
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