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| Fill in the registration form below, then choose 'send mail'. |
| All required fields are indicated with an asterix (*) |
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| *First Name: |
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| *Last Name: |
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| Company: |
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| *Address: |
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| *Town: |
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| Province: |
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| Country: |
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| *Postal Code: |
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| *Email: |
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| *Phone: |
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| *Date of Birth: |
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| * Gender: |
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Which gym do you currently attend? |
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Where did you first hear about the Challenge? |
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What date do you plan to start your Challenge? |
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Would you like to receive information on BFL, EAS products and offers in the future? |
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Submission of your completed Official Entry Kit in the Body-for-LIFE
2010 Challenge (2010 Challenge) constitutes your
express consent and permission for EAS Canada, and any of its
affiliated companies, and third party agents to use and disclose
your personal information in connection with the judging, review,
and promotion of the 2010 Challenge. You expressly acknowledge
that your personal information provided in connection with the
2010 Challenge may be viewed by EAS Canada and its affiliated
entities outside of Canada. |
