Replacement Pad Request - HELMETS FOR WATERSPORTS

Replacement Pad Request Form ( S1 Model only )

* All fields are required.

* Shipping to USA addresses only. For other countries please contact your point of purchase for replacement.

Full Name

Email Address

Phone Number

Shipping Address * USA SHIPPING ONLY

Where did you purchase your helmet Where did you purchase your helmet Simbahelmet.com In Store

If purchased via SIMBAHELMET.com please provide your order number

If purchased in store please provide the shop name

What was the date of your purchase

Helmet Size Helmet Size Small Medium Large

Pad Selection Pad Selection Green 9mm Blue 7mm

10 + 5 =