Asics New Zealand

Personal Details
Firstname:
Surname:
Email:
Gender:	Male Female
Date of Birth:	/ /
Street/P.O. Box:
Suburb:
City/Town:
Promotional code:		If you are entering your details with reference to the competition on the ASICS shoe box then please enter the promotional code on the sticker.

Which sports do you regularly participate in?		Do you currently use Asics footwear?
Running		Yes No
Trail/Off Road Running		If so, which model(s)?
Walking		Running:
Netball		Off Road:
Working out with Indoor equipment		Netball:
Cricket		Walking:
Hockey/Turf		XTraining:
Rugby		Indoor Court:
Track & Field/Racing		Tennis:
Other:		Other:
Where do you normally purchase your sports footwear from?

Other:
Yes, keep me informed.
No, leave me alone.