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Mind Body Workout System
Acceptance
Form

ORDER SECURELY ONLINE

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.
 

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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.
 

ADDtocart 

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.

ADDtocart 


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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