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To Order by Mail or Fax:
Mind Body Workout System
Acceptance Form
______ Yes, Dr. Nerenberg. I am ready to use the Mind Body Workout System to gain new control of my thoughts, feelings, and behavior. I am ready to experience the joy and satisfaction of having a greater depth of meaning in my life. I am ready to develop a new definition of the purpose of my life. I am ready to reduce negative states of my mind. I am ready to use the Mind Body Workout System for greater strength, health, and happiness. I am ready to overcome self-limitation and achieve my goals.
I understand that I have a full 12 months to use this system without risk. If I don’t receive the positive improvement I want after using your system, I may return everything in the original order and receive a full refund of the original purchase price. I also understand that I will receive a free one month membership in the Mind Body Workout Support System which includes a monthly teleconference, a CD of the call and bonus material to continually help me get the most out of the system. I understand that after the free month, the charge of $49.95 per month will be billed automatically to my credit card. Anytime I want, I can cancel and give up the membership with no further obligation.
Print and Fax this form to 1-310-826-4241 (or print and send form by mail, to the address at the bottom of this form)
Enter quantity
______ Start Now Package $97.00/ea. + sales tax if applicable
consists of “Law of Tribulation” DVD and CD, 8 minute Demo video of Mind Body Workout, the book “Gym Therapy” plus free month in the Mind Body Workout System Support Group, with a CD of the monthly call.
______ Gold Member Package $247.00/ea. + sales tax if applicable
consists of “Law of Tribulation” DVD and CD, 8 minute Demo video of Mind Body Workout, the book “Gym Therapy”
Plus: Dr. Nerenbergs “Cycle of True Progression” DVD, CD, Chart, “Empowerment of Tribulation” DVD, Cd. “Warrior Mindset” DVD, CD plus the book “The True Warrior Athlete”.
Plus 2 free months in the Mind Body Workout System Support Group, with a CD of the monthly calls.
Enclosed are my credit card details for the Mind Body Workout System and Mind Body Workout Support Group
Charge my:
__Visa __Mastercard __American Express
Card Number: _______________________________________________
Exp. Date: __________________________________________________
3-digit security code on back of your card ______
Print your name: _____________________________________________
Signature: __________________________________________________
Print Name Showing on Front of Card: ________________________________________________
Address (billing address): __________________________________________________
City: ____________________________________________ State: ______ Zip Code: __________
Country: _________________________________________________
Shipping Address (if different from billing address) ________________________________________
City: ____________________________________________ State: ______ Zip Code: __________
Country: _________________________________________________
Your Date of Birth: ____________________________________________
Telephone: ______________________________________________
Fax Number: _____________________________________________
E-Mail Address: __________________________________________________
Fax or Mail Your Order To:
Dr. Nerenberg’s Mind Body Workout
7238 S. Painter Avenue
Whittier, California 90602
Fax # 1-310-826-4241
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