Registration | Brake Buddy®

First/Last Name Enter Name

Required

Email Enter Email

Required

Message (Optional)

Phone Enter Phone Number

Required

Address Enter Address

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City Enter City

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State/Province Enter State/Province

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Zip/Postal Code Enter Zip

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Country Enter Country

Required

Purchase Date Enter Date (MM/DD/YEAR)

Required

Serial Number (Located on Backside of Brake Buddy)

Required

What is your age?

Required

21 - 29

50 - 69

30 - 49

70 or over

How did you hear about Brake Buddy®?

Required

Magazine

Web Forum

In-Store

From a friend

Internet Store

Fellow Camper

RV Rally

Other

RV Year Enter RV Year

Required

RV Make Enter RV Make

Required

RV Model Enter RV Model

Required

Vehicle Year Enter Vehicle Year

Required

Vehicle Make Enter Vehicle Make

Required

Vehicle Model Enter Vehicle Model

Required

Do you have more than one towed vehicle?

Required

Yes

No

How many trips do you take per year?

Required

0-5

6-10

11-15

Over 15

How many miles do you travel per year in your motorhome?

Required

Less than 1,000

5,000 - 10,000

1,000 - 4,999

Over 10,000

May we contact you for future research into new products?

Required

Yes

No

Enter Text

Required

System Purchased

Required

Select 3™

Classic 3™

Stealth™

Select II™

Classic II™