E-Mail ORDER FORM
Send all requests to:
Dynamic Fitness
3236 W. Sepulveda Blvd. #C
Torrance, CA. 90505
1-800-451-7274
Fax: 1-310-517-9608
Email: Jump Boots

BILLING NAME:
DATE:
ADDRESS:
PO#:
CITY:
STATE:
ZIP CODE:
BUYER TEL:
BUYER FAX:
SHIP VIA:
Visa :Master Card: American Express
CC#:
CARD EXPIRATION DATE:
E-Mail:

Product Name Shoe Size Your Weight
(lbs)
Male or
Female
Cost
1)
2)
Shipping/Handling (International Orders $25.00)
TOTAL

Dynamic Fitness
3236 W. Sepulveda Blvd. #C
Torrance, CA. 90505
1-800-451-7274
Fax: 1-310-517-9608
Email: Jump Boots

© Copyright 1996. All Rights Reserved

* Notice: Orders processed through unsecured e-mail. Submit at your own risk.

© Copyright 1996.
All Rights Reserved