ORDER REQUIREMENTS

	QTY	PRICE
Tunnel Harness £ 25.00	_____	_______
Please state Waist size ........................................... Upper thigh size ..................................	_____	_______
Post and Packing costs: UK Mainland and BFPO £2.00 , Europe £3.00, Rest of the World £6.00	_____	_______
TOTAL ORDER VALUE	_____	_______

DESPATCH AND PAYMENT DETAILS

Name.............................................................................................................................
Delivery Address.............................................................................................................
.....................................................................................................................................
Country.........................................................	Post/Zip Code..........................................
Telephone.....................................................	Fax.........................................................
Email...............................................................
Mobile.............................................................
Date order placed......../...../.....

Unfortunately, we aren’t able to offer ordering on line at the present time, but you can pay by the following methods: -

1. UK residents-cheque (sterling), banker's draft, MasterCard, Debit MasterCard, Visa Credit, Visa Debit. (Sorry we don't take Switch!) 2. All other countries - MasterCard, Debit MasterCard, Visa Credit, Visa Debit

I enclose a Cheque for the full order value of £ _____________ Made payable to ORIGINAL LIZARD Or: Please debit my credit card the amount of £ ______________ Credit card details: MASTERCARD / DEBIT MASTERCARD / VISA CREDIT / VISA DEBIT CARD HOLDER NO:

CARD EXPIRY DATE _____/_____

CARD HOLDERS ADDRESS AND POST/ZIP CODE (if different from the delivery address above)

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CARD HOLDER'S SIGNATURE..................................................................................

Please complete the above and return to us by one of the following methods:

POST: