Head First Foundation Helmet Order Form
Fill out and print this page, then please mail to:

Gateway Protective Gear
3965 Park Avenue, Suite 555
St. Louis, MO 63110
Name:
Street Address:
City: State: Zip:

Phone:

Method Of Payment:

Visa MasterCard Check or money order. Sorry, no COD's

Credit Card Number:

- - Expiration Date:

Name on Card (exactly):

Helmet Size in Inches:

Measure Circumference Of Head:

Helmet Style :

Your Cost :

One (1) Official Head First Team Helmet with this $20-off Coupon: $19.95
Shipping and Handling: $4.00
Missouri Residents Add Sales Tax: $1.15

Total Cost:

Make checks payable to: Gateway Protective Gear
All helmets shipped 2nd day priority mail.