Uplift Products Warranty Registration

Please complete this information within 30 days of purchase.

Date of Purchase: (MM/DD/YYYY)	(Required)
Model Number:	(Required)
Serial Number: (on paper warranty card)	(Required)
First Name:	(Required)
Last Name:	(Required)
Street Address:	(Required)
City:	(Required)
Province / State:	(Required)
Postal Code / Zip:	(Required)
Tel:	(Required)
E-mail:
Would you like to receive information on new and exciting products from Uplift in the future?	Yes - please send me information
VENDOR INFORMATION
Where did you purchase your Uplift Product?
Where did you hear about this product?
Was it a gift?	Yes it was a gift
What do you like about your Uplift Product?
Additional Comments? (i.e. ideas for other products etc...)

Thank you for taking the time to complete the information above.

NOTE: we do not make our customer information available to other vendors.