KEGEL FREE SAMPLE REQUEST FORM

Please choose the Kegel Product(s) you wish to try

TERRAIN LANE CONDITIONER

CURRENT LANE CONDITIONER

FIRE LANE CONDITIONER

ICE LANE CONDITIONER

CURVE LANE CONDITIONER

PLEASE HAVE A KEGEL TECHNICIAN CONTACT ME ABOUT ANOTHER PRODUCT NOT LISTED

Contact Name

First Name

Last Name

Contact Position

Organization/Company

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City

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Zip / Postal Code

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League Play vs Recreational/Open Play (%)

Distributor

Machine Serial Number

Date of Installation

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Conditioner Using Now

Cleaner Using Now

Cloth Using Now

Pinsetter Brand & Type

Number of Lanes

Underlayment/Foundation

Lane Surface Type

If synthetic what is the install year?

Pattern Length (ft)

Pattern Volume (mL)

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