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Quantity	Description	Price
	Clear Mouthguard	$100.00
	Clear w/ Logo (emailed pdf)	$110.00
	Clear w/ Custom Text	$120.00
	Clear w/ Custom Graphics	$145.00
	Single Color Mouthguard	$130.00
	Single Color w/ Logo (emailed pdf)	$140.00
	Single Color w/ Custom Text	$150.00
	Single Color w/ Custom Graphics	$175.00
	Two Color Mouthguard	$140.00
	Two Color w/ Logo (emailed pdf)	$150.00
	Two Color w/ Custom Text	$160.00
	Two Color w/ Custom Graphics	$185.00
	Three Color Mouthguard	$150.00
	Three Color w/ Logo (emailed pdf)	$160.00
	Three Color w/ Custom Text	$170.00
	Three Color w/ Custom Graphics	$195.00
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Fight-Bite Disclaimer: By signing this document (along with your heirs, executors, personal representatives, trustees, guardians, custodians, administrators, conservators, successors, assigns and transferees) have agreed to release KELLER GROUP ENTERPRISES, LLC, a Michigan Limited Liability Company, and its subsidiaries from all liabilities associated with performing your own impression for this mouth guard. You (along with your heirs, executors, personal representatives, trustees, guardians, custodians, administrators, conservators, successors, assigns and transferees) also agree that KELLER GROUP ENTERPRISES, LLC and its subsidiaries are not liable for the loss or damage of any teeth, gums, jaws or lips or any other injury sustained to the body while wearing any product manufactured, sold or distributed by KELLER GROUP ENTERPRISES, LLC and its subsidiaries. I agree to the Fight-Bite Disclaimer
Residents of Michigan must pay Michigan Sales Tax on this transaction. Please check the following box if you are a resident of Michigan. Checking the box will automatically add Michigan Sales Tax to the transaction. If you are a resident of Michigan and do not check the following box, you will be responsible for paying the Michigan Sales Tax for this transaction directly to Michigan. I am a resident of Michigan
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