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Billing Address

Shipping Address

Commercial       Residential      
Yes       No      
Studio/Teacher
Gym
Sporting Goods Retail
Online
Recreation Center
College/University
Spa
Gift Store
Other

We are required by the IRS to get a Taxpayer Identification Number from you. Please fill your Employer Identification Number (EIN) or Social Security Number (SSN) below and sign the officially worded IRS certification.

Under penalties of perjury, I certify that:
1. The number shown is my correct taxpayer identifcation number (or I am waiting for a number to be issued to me), and
2. I am not subject to backup withholding because: (a) I am exempt from backup withholding, or (b) I have not been notified by the Internal Revenue Service that I am subject to backup withholding as a result of a failure to report all interest or dividends, or (c) the IRS has notified me that I am no longer subject o backup withholding. (You must cross out this item if you have been notified by the IRS that you are curretnly subject to backup witholding because of underreporting interest or dividends on your tax return.)