BTL Bus Experience Event

BTL Bus Experience Event

Device Demo Registration
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Which Device Do You Want to Try?
ExoMind 1 - Time Slot - Please select only one time from one device.
ExoMind 2 - Time Slot - Please select only one time from one device.
ExoMind 3 - Time Slot - Please select only one time from one device.
EmSculpt Neo 1 - Time Slot - Please select only one time from one device.
EmSculpt Neo 2 - Time Slot - Please select only one time from one device.
EmFace/Exion 1 - Time Slot - Please select only one time from one device.
EmFace/Exion 2 - Time Slot - Please select only one time from one device.
EmSella 1 - Time Slot - Please select only one time from one device.
EmSella 2 - Time Slot - Please select only one time from one device.
Agreement:

I agree to arrive at least 5 minutes before my scheduled time slot. I understand that, due to the busy nature of this event, if I am late, my appointment may be given to the next available attendee.
Signature

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Date Signed

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Date
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