KBC Helmet Registration

* = Required Fields


Personal Information
Name*
Address*
City*
State*
Zip*
Your Email*


Purchase Information
Helmet Model/Color*
Snell # (Under Liner)
Promo Code*
Date Purchased*
Purchase From*
City*
State*
Zip*
Is this your first KBC helmet?*
 Yes  No
What other helmet brands have you owned?
What type of motorcycle(s) do you own?
What is your favorite Motorcycle Internet Site?
What influenced you in your purchase of this KBC helmet? (Select all that apply)
 Advertisement
 Dealer Recommendation
 Design/Features
 Fit/Comfort
 Friend
 Internet Information
 Price
 Style/Graphics
 Value Helmet Model
Which Motorcycle Magazines do you read regularly? (Check all that apply)
 Cycle News
 Cycle World
 Dirt Bike
 Dirt Rider
 Dirt Wheels
 Motorcross Action
 Motorcyclist
 MX Racer
 Racer X
 Rider
 Road Racer X
 Sport Rider
 Transworld Motorcross


        






KBC America, Inc.
2830 N. Ontario St.
Burbank, CA 91504

TEL. 001.818.526.7771
FAX. 001.818.526.7766
email: sales@kbchelmet.com
www.kbchelmet.com

KBC Europe Ltd.
Unit 1
Blakenhall
Cauldwell
Swadlincote
Derbyshire
DE12 6RU UK

TEL. 0044 (0)1283 763120
FAX. 0044 (0)1283 763121
email.sales@kbchelmets.co.uk
www.kbchelmet.com