Order Now A Bind Like No Other

JuRonCo
PO Box 5992
Peoria, IL 61601

"....A Bind Like No Other...."

Please fill out order form, print and snail mail.

SOLD TO

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Address

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St:
Zip:

Country

Phone number

E-mail address

SHIP TO

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Address

City:
St:
Zip:

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Phone number

QTY.	ITEM NUMBER	DESCRIPTION	PRICE	TOTAL

SHIPPING AND
HANDLING FOR
CONTINENTAL
USA


.	up to	$20,00	add $ 5.00
$20.01	up to	$30.00	add $ 6.00
$30.01	up to	$40.00	add $ 7.00
$40.01	up to	$60.00	add $ 8.00
$60.01	up to	$90.00	add $10.00
.	over	$90.00	add $13.00

SUBTOTAL
ILL. RESIDENTS ADD 7.25% SALES TAX
USE CHART AT LEFT TO FIGURE SHIPPING
TOTAL DUE

DOUBLE THE RATE TO ALASKA, HAWAII, CANADA, AND MEXICO. TRIPLE THE RATE EVERYWHERE ELSE.

METHOD OF PAYMENT (Sorry, no COD orders): Please do not send cash

Check or Money Order Credit Card credit cards

ACCOUNT NUMBER

EXPIRATION DATE

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PLEASE SUPPLY THESE MEASUREMENTS AS NEEDED:
Height Weight Chest Waist Coat Other

A bind like no other! DISCLAIMER" JuRonCo and all pertinent suppliers cannot accept any responsibility for injury during the use or misuse of these products, nor be a part to any illegal use. The buyer recognizes, acknowledges, and assumes all risk in any safe or unsafe use or misadventure. The undersigned states the products use will be restricted to theatrical productions of stage, screen, video, or magic. Signature and date required:

X____________________________________ DATE