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Name *

First Name

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Address

Address 1

Address 2

City

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Light Model *

Argon 3"

Atom 3"

Quantum 6"

Retro R10

Date of Installation *

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DD

YYYY

Installed in a: *

Pool

Spa

Pool/Spa Construction Type: *

Concrete

Fiberglass

Vinyl

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By submitting this form I hereby agree to the terms and conditions of Spa electrics Pty Ltd Warranty Policy *

Yes, I Agree.