Your Name *

Your Email Address *

Phone Number *

Address *

City *

Country *

Postal Code / Zipcode *

What product is this about? *

Bindings serial number

(ex. 4H16-05979)

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Bindings model *

Bindings model name *

Bindings problem area *

Bindings toe piece issues *

Bindings heel/turret piece issues *

Brake Issues *

Skins model name *

Plush type *

Climbing Skins serial number *

Climbing Skins problem area *

Plush Issues *

Glue Issues *

Tip Issues *

Tail Issues *

Ski model name *

Skis model name *

Skis serial number *

Skis problem area *

Skis issues *

Splitboard model name *

Splitboard serial number *

Splitboard problem area *

Splitboard issues *

Avalanche product name *

Probe issues *

Shovel issues *

Poles model name *

Poles issues *

Accessories product name *

Size (Write N/A if not applicable) *

Accessories issues *

Date of Purchase *

Proof of Purchase

Photos of Affected Unit *

Please provide multiple photos of the damage

Description of Damage / Notes *

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