Registration | Brake Buddy®

First/Last Name Enter First/Last Name

Required

Email Enter Email Address

Required

Message (Optional)

Phone Enter Phone Number

Required

Street Address Enter Street Address

Required

City Enter City

Required

State/Province Enter State/Province

Required

Zip/Postal Code Enter Zip/Postal Code

Required

Country Enter Country

Required

Purchase Date Enter Date

Required

Serial Number (Located on back side of the Brake Buddy)

Required

What is your age?

Required

21 - 29

50 - 69

30 - 49

70 or over

How did you hear about Brake Buddy®?

Required

Magazine

Web Forum

In-Store

From a friend

Internet Store

Fellow Camper

RV Rally

Other

RV Year Enter RV Year

Required

RV Make Enter RV Make

Required

RV Model Enter RV Model

Required

Vehicle Year Enter Vehicle Year

Required

Vehicle Make Enter Vehicle Make

Required

Vehicle Model Enter Vehicle Model

Required

Do you have more than one towed vehicle?

Required

Yes

No

How many trips do you take per year?

Required

0-5

6-10

11-15

Over 15

How many miles do you travel per year in your motorhome?

Required

Less than 1,000

Between 5,000 - 10,000

Between 1,000 - 4,999

Over 10,000

May we contact you for future research into new products?

Required

Yes

No

If Other Enter Source

Required

System Purchased

Required

Select 3™

Classic 3™

Stealth™

Select II™

Classic II™