NAME |
MAILING ADDRESS |
CITY |
STATE |
ZIP CODE |
EMAIL ADDRESS VVVV |
PHONE NUMBER |
Ephedra LIPODRENE SAMPLE ? |
Stemerex WITH EPHEDRA? |
Ephedra 1200 tea Sample ? |
FILL OUT FOR FREE DIET |
Please fill out the form below as accurately as possible and submit it. Within 7 days you will have your free sample SO ORDER SOME FAT BURNERS! CALL IN FOR REDUCED SHIPPING AND SPECIAL DEALS! 1-877-808-0032 ITs WEIGHTLOSS TIME. WEIGHTLOSS !! |
FREE SAMPLE CONGRATULATIONS! YOU are here to lose weight! |
How did you hear about my site? (Put answer below, Please.) |
FITNESS TIME |
VALID email must be given for US MAIL>> address confirmation required! NO email address, no sample! |
The shopping cart buttons will take you to the shopping cart. You must call 1-877-808-0032 toll free to get 10-30% off of my regular prices, (except ephedrine products) If you want just the free sample, fill out the form and click "I Agree/submit. IF YOU DO NOT AGREE TO THE DISCLAIMER, YOU WILL ERASE YOUR REQUEST AND SEND ME A BLANK SAMPLE REQUEST FORM. YOU MUST AGREE TO THE DISCLAIMER TO RECEIVE A FREE SAMPLE, FREE DIET, OR FREE SUPPLEMENTS, BRONCHIAL DILATORS, Herbal Supplements, OR OVER THE COUNTER MEDICATIONS. The FDA is now in court, trying to get ephedra banned again. Believe it or not, EPHEDRA may be banned this month! I suggest you buy as much as you can while you can...I know I will. |
Try my own ephedra labels! They are awesome! (Just click on the pic of what you want, and it will take you to the ephedra section of the shopping cart where they are all listed.) |
I will validate your address by your email or phone number before I send your sample regular mail. CHECK YOUR EMAIL THE NEXT DAY AFTER YOUR REQUEST! |
Type in Yes or no in each box to let me know which sample you want. VVVVVVVVVV VVVVVVVVVVVVVV VVVVVVVVVV |
Remember: you must give me a valid phone number or email so I can check your address, so I won't waste postage. |
You must be 18 years of age or older. All chinese herbal samples, ingrediets, supplements, diets are at your own risk. Please consult with your physician before using any of my herbal remedies, diets, supplements, or exercise programs. Read all warnings and directions on all supplements and Chinese Herbal remedy and tea labels. If you have any adverse reaction to a diet, free supplement, Chinese Tea or Remedy from this web site, stop taking it and call your physician! FRAUD IS PROHIBITED ON THIS SITE. By submitting a request for a free sample or diet from this web site, you agree to hold Jim Jackson, JJs Diet Fitness and all employees of JJs Diet Fitness Harmless and Blameless of any and all injuries or reactions resulting from any program, free sample, supplement, herbal Chinese Tea or Remedy, bronchial dilator, over the counter medication, diet sold or given away from any JJs Diet Fitness web site or affilated business site anywhere. |
