FREE "Play Hard, but Play Safe" t-shirt with orders of 2 or more videos.  

Only orders placed online or using this form will receive the free t-shirt (while supplies last) 

Name:   ______________________________  
Address:   ____________________________   
Address:   ____________________________  
City/State/Zip:  ________________________   
Country:   ____________________________   
Phone:  ______________________________   
Email:   ______________________________   
Date:    ______________________________  

PAYMENT METHOD (please circle one):  

VISA    MC    AMEX    Check    Money Order 

CARD #  
   I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I__I 
Expiration Date (Month) ____     (Year) ____  
Card Holder Name  (please print) _________________________________  

Authorized Signature: 

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Cardio Athletic Kickbox (VHS)
  Quantity:  _____          Price:   $12.95 

Cardio Athletic Kickbox II - Play Hard...(DVD) 
  Quantity:  _____          Price:   $19.95  

Cardio Athletic Kickbox II - Play Hard...(VHS) 
  Quantity:  _____          Price:   $16.95   

Kickbox I and Kickbox II - 2 Video Set (Free t- shirt)
  Quantity:  _____          Price:   $29.95 

Kickbox Video Gift Set - 3 VHS Videos (Free t- shirt)
  Quantity:  _____          Price:   $39.95 (Save $10.00)

Cardio Athletic Kickbox - No Holds Barred (DVD)

  Quantity:  _____          Price:   $19.95 

Cardio Athletic Kickbox Instructor Series I (VHS)

(DVD is entitled "No Holds Barred")
  Quantity:  _____          Price:   $16.95 

Hatha Vinyasa Yoga (VHS)
  Quantity:  _____          Price:   $24.95   

VHS PAL For Europe, United Kingdom, 

Australia, etc: Add $3.00 per video 
  Quantity:  _____          Price:   $3.00   

Please send payment to:  
Behind the Scenes Fitness  
65 Washington Street, Suite 296  
Santa Clara, CA 95050  (United States)
phone:   1-408-244-4895 

Subtotal (Price x Quantity)                 _______  
Sales Tax (Calif. residents add 8..25%)_______  
USA Shipping (1 Video)       $4.75 (International Shipping Add $4.00)

Add $1.00 shipping for  
each additional video                        ________  

TOTAL                                 $________