PRICING-REORDERS ONLY
Gladiator® Pro
Solid color retail price $78.00
Custom Mouth guards
Brick township memorial h s
For SGI use:
Brick Mem. HS reorder $ 25.00
_______
Second guard price
_______
Invoice# _____________
$ 25.00
UPGRADES
Raptor®
SGI has a “Chewers” material upgrade.
No discount available.
$ 6.00 ea _______
**NOT available with braces**
Age: ___________
Class:_____________
Athlete’s Name: ______________________________
Home Address: ______________________________
City, State, Zip: ______________________________
Phone: ______________________________________
Power Grip®
retail $20.00
Athletes having suffered a severe or
multiple concussions:
$ 10.00 ea _______
** NOT available with Raptor™
Stripes:
$ 5.00 ea _______
Metallic Gold on Black / Black on Metallic Gold
Email:______________________________________
Sport: _____________________________________
Gladiator® Pro
BLACK
$ ________
***** ONLY FOR REORDERS ****
If you had a mouth guard made last year, you only need a
replacement/reorder. Parent club cannot pay for reorders.
STANDARD OPTIONS
(Circle Selection)
COLOR:
TOTAL
METALLIC GOLD
PAYMENT INFORMATION
Please make checks or Money orders Payable to:
LOGO:
Sport Guard Inc.
For a Visa OR MasterCard, complete the following:
Name on Credit Card:
____________________________________
#1
PERSONALIZATION:
Identification on the side of your Gladiator®
#2
Suggestions: your name, nickname OR number
$ 6.00
Power Grip® $ 10.00
Exact Address credit card bill is sent to:
City, State, Zip: ______________________________
YES
Metallic Gold on Black / Black on Metallic Gold
Raptor™
____________________________________
______________________________________
UPGRADE OPTIONS
(Circle Selection)
$ 5.00
NO AMERICAN EXPRESS
Expiration Date:___________ Security #________
MAXIMUM 7 CHARACTERS
Stripes:
Credit Card #
YES
YES
Shipping & Handling: __N/C Group Order____
Number of Gladiators® ordered
________
Questions Please Call 1-877-8-GUARDS
Email: sales@gladiatorguards.com
WWW.GLADIATORGUARDS.COM