*First name:

Last name:

*Club/School name:

Mobile no.:

Landline no.:

*Email address:

Address & Postcode
where machine can be found:

Precise description of machine location at premises:

If machine is locked away, who will provide access...

Name:

Mobile no.:

Landline no.:

Email address:

Number of machines for servicing:

Sled:

Rollers:

Do you require the Rhino Engineer to be accompanied?

Yes No

If authorisation is required prior
to fitting of spare parts please give details:

If possible please send digital images of equipment to: peter.urey@rhinorugby.com

Club/School purchase order reference:

Name:

Address:

Postcode:

Telephone:

Email: