(Please complete and return this form only if you wish to withdraw from the contract.)

To Thermo-Life Customer Service,

Lytchett House,
13 Freeland Park,
Wareham Road, Poole, Dorset, BH16 6FA
United Kingdom

(info@thermo-life.com):

I/we (*) hereby notify you of my/our (*) withdrawal from the contract relating to the sale of goods (*)/for the provision of services (*) below:

Ordered on (*)/received on (*):

Name of consumer(s):

Address of consumer(s):

Signature of the consumer(s) (only in case of notification of this form on paper):

Date:

(*) Cross out what does not apply.