PRICING- NEW ORDERS ONLY
Gladiator® Pro
Solid color retail price $78.00
Custom Mouthguards
Brick township memorial hs
For SGI use:
Brick Mem. HS
$ 45.00
_______
Second guard price
$ 25.00
_______
Invoice# _____________
UPGRADES
Raptor®
Age: ___________
Class: _____________
Athlete’s Name: ______________________________
Home Address: ______________________________
City, State, Zip: ______________________________
Phone: ______________________________________
Email:______________________________________
SGI has a “Chewers” material upgrade.
No discount available.
$ 6.00 ea _______
**NOT available with braces**
Power Grip®
retail $20.00
Athletes having suffered a severe or
multiple concussions:
$ 10.00 ea _______
** NOT available with Raptor™
Stripes:
Metallic Gold on Black
TOTAL
FOOTBALL
$ ________
New orders only: Grade 10 in 2013 or
new player.
Gladiator® PRO
STANDARD OPTIONS
(Circle Selection)
COLOR:
$ 5.00 ea _______
Parent Club will pay $20.00 towards the
purchase of your 1st Mouth Guard. Please
deduct $20.00 from your calculated total.
BLACK
LOGO:
Total Due: $__________
Parent club: -$20.00
#1
PERSONALIZATION:
Identification on the side of your Gladiator®
#2
MAXIMUM 7 CHARACTERS
Suggestions: your name, nickname OR number
$ 5.00
YES
Metallic Gold on Black
Raptor™
Please enclose your check or money order made
payable to Sport Guard, INC.
For Visa or Master Card: NO American Express
Name on CC: _____________________________________
UPGRADE OPTIONS
(Circle Selection)
Stripes:
Balance Due: $ ______________
Credit Card #: ____________________________________
Expiration Date: _____________Security #: ____________
$ 6.00
YES
Power Grip® $ 10.00
YES
Exact Address credit card bill is sent to:
City, State, Zip: ______________________________________
Number of Gladiators ordered: _______________________