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Repair Request
Repair Request
NVarra
2017-09-19T13:51:30+00:00
EM Repair Request / Warranty Claim
Complete the form below in detail to begin your Electric Motion warranty claim process. After submission of the warranty claim form, an Electric Motion representative will contact you within 24-48 hours.
Name
(required)
E-mail Address
(required)
Phone Number
(required)
Claim Date
(required)
Year of Bike
(required)
2013
2014
2015
2016
2017
2018
2019
2020
2021
Model of Bike
(required)
Lite
Escape
Sport
Trek
Purchase Location
(required)
Purchase Date
(required)
VIN Number
(required)
Located on head stock or invoice
Purchase Invoice
Attach a PDF or JPG of your original invoice
Attach a PDF or JPG of your original invoice. Maximum size 10MB.
Battery Serial Number
(required)
Claim Description
(required)
Please provide a detailed description of the issue.
By accepting this you will: RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY! IN CONSIDERATION of authorizing Electric Motion North America (2243360 Ontario Inc) to perform repair work or provide advice on my EM devices, related parts including batteries and motors. I understand that
Electric Motion North America (2243360 Ontario Inc)
technicians have been trained to perform work on EM devices . Further, I agree to release, indemnify, and hold
Electric Motion North America (2243360 Ontario Inc)
from liability for any claims or damages of any kind or description that may arise from
shipping, advice or any repair work
performed on my EM devices, parts and batteries. For now and in the future, I, for myself, my personal representatives, assigns, heirs, and next of kin:
HEREBYRELEASE, discharge, and covenant not to sue Bob Billyard and/or 2243360 Ontario Inc., their personal representatives, assigns, heirs and next of kin, (each considered on of the Releasees herein) from all liability, claims, demands, losses or damages , or anyone on my behalf, makes a claim against any of the Releasees, I WILL INDEMNIFY< SAVE AND HOLD HARMLESS each of the Releasees, from any litigation’s expenses, attorney fees, loss, liability, damage, or cost which any may incur
as a result of such claim. I have read this agreement, fully understand its terms, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this agreement is held to be invalid, the balance, notwithstanding, shall continue in full force and effect.
I Accept THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT
I Accept THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT
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