Edelrid Smart Belay Servicing

{yourName}

Here is the information you submitted to get your Edelrid Smart Belay units serviced.

Please take the following steps to get the items to Edelrid.

1) Print out the attached PDF version of this form. (You might need multiple copies)

2) Place a print out in EACH box you send.

3) Package the units in a study box. You many use multiple boxes.

4) Ship via UPS or Fedex to:

Edelrid North America
Attn: Paul Nanawa

736 SW Umatilla Ave, Suite H

Redmond, OR 97756

{form_title}

Return Authorization #	{returnAuthorization}
Your Company/Organization/School Name:	{yourCompanyorganizationschool}
Your Name:	{yourName}
Your Email:	{yourEmail8}
Your Phone Number	{yourPhone}
How many units will you be sending in:	{howMany12}
Address we should ship the units to after inspection/repair:	{addressWe}
Signature confirming you agree to the outline above	{signatureConfirming}
Date	{date}

Return Authorization #

If you have been given one.

Your Company/Organization/School Name:

Your Name:

Your Email:

example@example.com

Your Phone Number

Please enter a valid phone number.

How many units will you be sending in:

Address we should ship the units to after inspection/repair:

Signature confirming you agree to the outline above

Clear

Date