ONLINE HELMET ORDER FORM


Freight is calculated per helmet using UPS ground rates or Expedited Postal rates plus insurance.

Pricing is in Canadian dollars.
GST will be added to all Canadian orders.
PST is added only on Ontario and Maritime orders.

All helmets purchased are final sale.
 If the helmet does not fit properly it may be returned, for exchange only, in its original packaging. It must be shipped back to us within 24 hours of delivery. You must phone for authorization before you return a helmet. All freight and brokerage will be the responsibility of the purchaser.
All prices are FOB Newmarket, Ontario

CUSTOMER INFORMATION:

E-Mail Address:
First Name:
Last Name:
US Customs requires SS# for US customers:
Address:
City:
Province/State:
Postal Code/Zip Code:
Daytime Phone#:

SHIPPING INFORMATION:

Business Name:
Address:
City:
Province/State:
Postal Code/Zip Code:
Phone#:

Type Of Payment

Name on Credit Card
Card Number
The 3 digits at the end of the signature strip on the back of your card:
Date Card Expires (mm/yyyy)
REVIEW HOW TO SIZE

Are you ordering a HANS® device from us?     Yes     No


I WOULD LIKE TO ORDER THE FOLLOWING HELMET(S)

Centimeters:
Helmet Color:


Centimeters:
Helmet Color:


Centimeters:
Helmet Color:


Centimeters:
Helmet Color:


Enter anything else we should know



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