RESCUE, SAFETY & TRAINING EQUIPMENT ORDER FORM Sold to name: Ship to name:

Mailing address: Street address (please do not use post office box)

City Prov Postal code City Prov Postal code

Ordered by: Attention:

Phone: Phone:

Date ordered: Date required:

Payment: Cheque Money order Purchase order # VISA Debit MasterCard AMEX

Credit Card # Expiry date Cardholder’s name Cardholder’s signature

Items are shipped prepaid. Shipping charges will be added to your bill. If you require an estimated shipping cost, please call us at 416 490 8844. HST Extra. QTY CODE ITEM PRICE TOTAL 41.8160.00 Rescue Board by Dolphin Surf Craft $1,450.00 41.8170.00 Board by Dolphin Surf Craft $1,575.00 41.8171.00 Soft Rescue Board by Dolphin Surf Craft $1,199.00 42.7160.00 Throw Line / metre $1.65 42.9160.10 Throw Line Spool (183 m) $211.37 41.8138.00 Throw Bag with 50 ft. of Safety Line $38.00 42.1183.00 New Society Competition Manikin $298.00 42.1185.00 New Lifesaving Society Training Manikin $175.00 42.1192.00 New Competition Manikin Screw Cap Replacement $17.50 41.8140.01 Life Hook Only (No Bolts) $28.79 41.8143.00 8-16’ Rescue Pole Only – Adjustable (no bolts) $74.93 41.8144.00 Lifehook with 8-16’ Pole & Bolts $85.39 41.8134.00 Ring Buoy – 20” Plastic (no line attached) $88.00 41.8135.00 Ring Buoy – 24” Plastic (no line attached) $99.00 41.8130.01 Ring Buoy - Orange 20” Dense Foam (no line attached) $83.00 41.8132.00 Ring Buoy – 24” Dense Foam (no line attached) $98.43 41.8100.00 Kiefer Rescue Can (Yellow) 27” $103.50 41.8100.60 Kiefer Rescue Can (Red) 27” $103.50 41.8105.60 Rescue Tube (Red) 40” $84.46 (Order 12+ and pay $71.79) 42.7400.00 Lifesaving Rescue Tube – (Yellow) 37” $72.50 (Order 20+ and pay $61.63) PRICES EFFECTIVE UNTIL DECEMBER 31, 2011* SUB TOTAL *Prices are subject to change without notice (Continued….)

400 Consumers Road, Toronto, ON M2J 1P8 Phone 416-490-8844 Fax 416-490-8766 E-mail : [email protected] Web site: www.lifesavingsociety.com

RESCUE, SAFETY & TRAINING EQUIPMENT ORDER FORM Page 2 QTY CODE ITEM PRICE TOTAL 41.8113.00 Yellow Plastic Spineboard Beavertail only – 30 cm $63.00 41.8111.01 Spineboard Wall Hook (each hook) $35.00 41.9109.00 Grey V-Block Spineboard w. Wall Bracket, includes Tspt Strap (No $665.00 Beavertail) 41.9109.01 Grey V-Block Spineboard w. Wall Bracket Tspt Strap & Beavertail $740.00 installed 41.8118.01 V-Block Soft Rubber Beavertail only $55.00 41.8111.00 V-Block Steel Spineboard Wall Bracket $33.00 41.8126.00 V-Block Head Immobilizer with strap $115.00 41.8120.00 Universal Head Immobilizer (UHI) with Strap Mounting $99.00 41.8121.00 Universal Head Immobilizer replacement straps (pair) $31.00 41.8119.00 V-Block head support transport strap $28.95 41.8119.01 V-Block Head Strap $9.25 41.8116.03 V-Block Spineboard Straps (Set of 4 Velcro) $66.00 41.8127.00 Replacement V-Block Foam (4 pieces) $13.25 41.8128.00 V-Block Velcro Fuzzy Strips for Spineboard (each) $7.50 41.8128.10 V-Block Velcro Non-Fuzzy Strips for Spineboard (each) $7.50 41.8102.00 Loop ‘N’ Line $27.75 41.8110.00 Yellow Plastic Spineboard (No Beavertail) $589.00 41.8110.01 Yellow Plastic Spineboard (With Beavertail Installed) $677.00 41.8122.10 UHI Bolt Kit for ½ “ Plastic Boards $5.75 41.8122.00 UHI Bolt Kit for ¾ “ Plywood Boards $5.75 41.8116.02 Spineboard Generic Straps (Set of 4 Velcro) $62.30 41.8117.02 Spineboard Generic Straps (Set of 4 Buckle) $50.00 41.8117.03 Yellow Spineboard Replacement Straps (Set of 5 Buckle) $81.00 41.8150.01 Large Powered Megaphone $113.30 41.8151.00 Mini Megaphone $77.25 41.8329.00 Large Waist-Pac – Lifesaving Society Logo (empty) $44.50 41.8330.00 Small Waist Pac - Blue (empty) (Order 12+ and pay $9.14) $10.75 41.8136.00 SS Ring Buoy Wall Hooks $15.84 42.1202.00 Easy-Grip Brick – 5 lb. (Orange) $35.59 42.1200.01 Easy-Grip Brick – 10 lb. (Blue) $51.24 42.1201.01 Easy-Grip Brick – 20 lb. (Yellow) $92.19 42.9200.00 Easy-Grip Brick Combo (1 of each 5/10/20 lb.) $152.17 TOTAL FROM PREVIOUS PAGE TOTAL FROM THIS PAGE Need Equipment? Download our First Aid Equipment Order Form. SHIPPING TAX PRICES EFFECTIVE UNTIL DECEMBER 31, 2011* TOTAL *Prices are subject to change without notice

400 Consumers Road, Toronto, ON M2J 1P8 Phone 416-490-8844 Fax 416-490-8766 E-mail: [email protected] Web site: www.lifesavingsociety.com