Warranty Registration

Tuesday, May 21, 2013

CHAMPION TRIKES
TOLL FREE: 1-800-875-0949

Please fill out the form below to register your Limited Warranty:

Order Confirmation Number:	(6 digits)
Product(s):
Last Name:
First Name:
Address:
City:
State/Province:
ZIP Code:
Country:
Day Phone:	(555-555-5555)
Evening Phone:	(555-555-5555)
Installed By:	Self Installed Dealer Installed
Installing Dealer:	(name, city, state)
Motorcycle Make:	Make Model Year
Motorcycle Mileage:
Date of Purchase from Dealer:	(mm/dd/yyyy)
Original Product Owner?	Yes No
	(If "No", bought from)
	(If "No", bought from phone)
Warranty Card Tracking # (accessories only):	(5 digits pre-printed on card)


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