Mountain Buggy Product Registration Form

Name and Address

First Name:
Last Name:
Address 1:
Address 2:
City:
State / Province:
Zip / Postal Code:
Country:

Contact Details

Telephone Number:
Email Address:
Fax:

Purchase Details

Date of Purchase:
Shop / Store Name:
Shop / Store Location:

Family Details

Your age:

Under 25

25 - 34

35 - 40

40+
Number of chlidren:
Youngest child:

Feedback

What sold you on our product?:

Sales Person

Store Location

Price

Previous use of product

Functionality

Other
How did you hear about Mountain Buggy?:
On a scale of 1 - 10 (10 being very likely), how likely is it that you will recommend Mountain Buggy products to family, friends or colleagues?:
What is your next purchase likely to be?:
What do you like about your product?:
What would you do to improve it?:

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