Free* Helmet Form for Tandem Purchase (USA ONLY)

*A Nominal Shipping and Handling Fee Applies
Free Helmet Promotion for USA Lower 48 States Only

Instructions:
If you purchased a qualifying tandem product, and are entitled to 2 free helmets, please fill out this request form and click the submit button below. Helmet will be shipped to the original shipping address from the original order's qualifying purchase. If your shipping address has changed, please let us know in the comments box.

Please fill in your credit card information below:
*S&H Fee: $14.98 to $16.98 based on destination

 

 

 

Email Address:
 
Order Number (numbers only please:)
 
Your name as it appears on your credit card:
 
Credit Card Type: Visa/MC/Discover
 
Credit Card Number (XXXX-XXXX-XXXX-XXXX):
 
Expiration Date (mm-yy):
 
C V V Code (XXX):
   
 
Helmet Sizing Chart:
S/M (22 in - 23 5/8 in)
L/XL (23 5/8 in - 25 3/4 in)
Helmet #1 Size & Color: (If this color is unavailable, alternate color will be sent)
   
Helmet #1 Alternate Size & Color: (Pick a different color in the same size. If this color is unavailable, we will choose a color)
   
Helmet #2 Size & Color: (If this color is unavailable, alternate color will be sent)
   
Helmet #2 Alternate Size & Color: (Pick a different color in the same size. If this color is unavailable, we will choose a color)
 
Comments:
Enter Verification Code if shown:


Helmet typically ships the day after your bike ships. This offer expires 60 days from date of original qualifying purchase or if mail-in, in conjunction with postmark date on free item request envelope. If promised item becomes unavailable, UBCSE LLC reserves the right to substitute for another item of equal or greater value.

TERMS AND CONDITIONS:
Limit of one free item per household, per product, per offer. All eligible products must be purchased during the promotion period (if stated above) and must be identified on one order or receipt. All submissions are subject to purchase validation, returned products are not eligible for free item. Product may not be returned for full purchase price once the item has been fulfilled. Customers who receive a price match will not be eligible for the free item. Those who receive a free item and later receive a price match, will have the value of the free item deducted from the price match. UBCSE LLC and its fulfillment companies are not responsible for incomplete, illegible, late, lost, mutilated, misdirected or postage-due requests. If mailing this form, all requests for each free item must be sent in separate envelopes, postmarked by the offer deadline, and sent to the address listed on this form. Fraudulent submission of multiple requests and/or providing false information disqualifies this request and could result in federal prosecution for U.S. Mail Fraud. UBCSE LLC reserves the right to deny and/or disregard any free item request if deemed to be false or fraudulent. Information submitted with any free item request will be handled according to the UBCSE LLC Privacy Policy, which can be found on our website. Offer void where prohibited or restricted by law. Requests from UBCSE LLC employees will not be honored or acknowledged. Keep a photocopy of all materials submitted for your records. B.biz45125

FREE HELMET POLICY:
Permission is granted to electronically copy and to print hard copy portions of this page for the sole purpose of obtaining an entitled item. Any manipulation or alteration of the form or other use of materials on this site, including reproduction for purposes other than as noted above, modification, distribution or republication, is strictly prohibited. Fraudulent submission could result in federal prosecution under mail fraud statutes (Title 18, United States Code, Sections 1341 and 1342). By submission of this form, you agree to be bound to all rules and regulations placed upon the free item by either the manufacturer, UBCSE LLC, or their parent, sister, or child companies.

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