LS2 Helmets (Carbon) Warranty and Insurance Activation

Full Name (As per NID/Passport/Birth Certificate) *
পূর্ণ নাম (আপনার এনআইডি/পাসপোর্ট/জন্ম সনদ অনুসারে)

Date of Birth *

Mobile *

Email (Optional)

Dealer Name *

Helmet Purchase Date *

Helmet Model * Select MX703 X-FORCE OF603 INFINITY II FF805 THUNDER FF811 VECTOR II FF901 ADVANT X OF601 BOB II

Purchase Receipt/Invoice *

Please upload a clear photo of the purchase receipt/invoice

Nominee Name *

Nominee Relationship With Enrolled Person * Spouse Child Father Mother Sibling

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