Health Fitness Center Form

Send this form along with check/money order payable to: Dreams Distribution, Inc.

513 Hopper Drive • Corpus Christi, TX 78411 • (877) 419-1729

QTY ITEM PRICE TOTAL
THE SPORTS BREATHER $29.95 $
**SHIPPING & HANDLING $
TOTAL $
**SHIPPING/HANDLING IS $4.00 ~ FOR EACH ADDITIONAL BREATHER ADD $1.00
NAME
E-MAIL
MAILING ADDRESS
CITY, STATE, ZIP
PHONE NUMBER