[av_textblock size=” font_color=” color=”]

Register your warranty

To help us validate your 1 Year RTB (Return To Base Warranty) please complete and submit the form below within 1 month of your Aqualite screen purchase.

Should you have any queries with your new screen, in the first instance, please contact your Aqualite retailer.
[/av_textblock]

[av_contact email=’kim@aqualiteoutdoor.com’ title=” button=’Submit’ on_send=” sent=’Your guarantee is registered!’ link=’manually,http://’ subject=” autorespond=” captcha=” form_align=” color=”]
[av_contact_field label=’Name’ type=’text’ check=’is_empty’ options=” multi_select=” width=”][/av_contact_field]
[av_contact_field label=’Address’ type=’text’ options=” check=’is_empty’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Telephone’ type=’text’ options=” check=’is_phone’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’E-Mail’ type=’text’ check=’is_email’ options=” multi_select=” width=”][/av_contact_field]
[av_contact_field label=’Product Model Mumber (i.e. AQLS-42)’ type=’text’ options=” check=’is_number’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Serial Number (i.e. S/N: AS42000010)’ type=’text’ options=” check=” width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Supplier (if known)’ type=’text’ options=” check=” width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Date of Purchase’ type=’datepicker’ options=” check=’is_number’ width=” multi_select=”][/av_contact_field]
[av_contact_field label=’Environment screen will be used in:’ type=’textarea’ options=” check=” width=” multi_select=”][/av_contact_field]
[/av_contact]