ORDER FORM
View product/order online at
(Your discount will be calculated automatically.)
Fax: - (604) 980-1085 Tel: 1 877 499 7999
Or email to:
NAME: DATE:
COMPANY NAME & ADDRESS:
TEL:
EMAIL:
SHIPPING ADDRESS (if different from above):
For pole orders of 50-100 sets or more, please contact us for special pricing!
Platinum Package; Order 30 poles in any combination and save 45%.
Gold Package; Order 20 poles in any combination and save 40%
Silver Package; Order 10 poles in any combination and save 35%.
Minimum Order (5 to 9 poles) Save 25% off our regular pricing
Pole Order
Qty / DESCRIPTION / UNIT PRICING (circle one)Platinum Gold Silver 5-9 poles / TTOTAL
Series 300 (reg. $99.99) (blue) / 54.99 59.99 64.99 74.99
4Life Pink (reg. $99.99) (hot pink) / 54.99 59.99 64.99 74.99
Adventure Series (reg. $114.00) (snowshoeing/hiking) / 61.99 66.99 71.99 81.99
Activator (fall special $89.99) (rehab & older adults) / 54.99 59.99 64.99 74.99
Accessories (save up to an additional 45% when you order your accessories with poles!)
Qty / DESCRIPTION / UNIT PRICE / SIZING / TOTALSnow/Trekking Baskets 5-pack / $39.95
Carry Bags 5-pack / $64.95
Replacement Tips 5-pack / $64.95
Bell Tips 5-Pack / $64.95
Steps Count Pedometers / $29.99
Instructional DVDs 5-pack / $14.95
Instructor Shirts (White) / $24.99 / Men’s/Ladies’
Note: Ladies’ only also avail in XL / S / M / L XL
Course Registration
Urban Poling (Nordic walking) Instructor & Rehab/Wellness Courses registration fee includes 1 set of poles and 50-page manual (Instructor Course only also includes an instructor shirt)
Qty / DESCRIPTION / UNIT PRICE / DISCOUNT / TOTALUP Instructor Certification – LIVE
Location & Date:
Shirt Size: Poles (circle one): Series 300 4Life / $229.99
UP Course for Rehab & Wellness – LIVE
Location & Date:
Poles (circle one): Activator Series 300 4Life / $229.99
UP Instructor Cert. – ONLINE
Shirt Size: Poles (circle one): Series 300 4Life : / $229.99
UP Course for Rehab & Wellness – ONLINE
Poles (circle one): Activator Series 300 4Life / $229.99
Bonus Offer!*
Order 30 sets of poles now & online course registration for 2 people is free!
Order 20 sets of poles now & online course registration for 1 person is free!
Name of free registrant:
Email:
Name of additional person for course registration:
Email:
* Note: Bonus offer course registration is for our online course only & does not include additional poles or shirt
Payment Details
Method of Payment: / Card NumberVISA / Exp. Date:
MASTER CARD / Card Holder Name:
AMEX / Signature:
□We are a centre and would prefer to be invoiced.
Shipping & Handling fees and applicable Taxes for your area will be added to your order total.
**Contact us if you want a local retailer to carry our poles for your clients instead.