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|                    Lifeguard 1.01 Registration Form                     |
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|                                                                         |
|  Name         :    ...............................................      |
|                                                                         |
|  Address      :    ...............................................      |
|                    ...............................................      |
|                    ...............................................      |
|                    ...............................................      |
|                                                                         |
|  I enclode a cheque/cash for 10.                                       |
|     (Cheques made payable to `Jon Ribbens')                             |
|                                                                  FRN0.02|
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|                    Please allow 28 days for delivery                    |
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Send to :

               Jon Ribbens
               39 Nutkins Way
               Chesham
               Bucks
               HP5 2BE
