DESCRIPTION
PRICE EACH
QTY
SUB TOTAL
Luminous Brites Free Trial
$0.00
1
$0.00
S&H:
Standard Shipping - 5.99
Expidited Shipping - 7.99
$5.99
1
$5.99
Yes, please insure my order for only $1.00
$1.00
$1.00
Includes enrollment in value shipment program
Total:
$5.99
YOUR INFORMATION
How the free trial program works!
Upon ordering you agree to pay the shipping and handling fees for the free trial supply. If you enjoy the product do nothing and 20 days after your order you will be billed using the same credit card you used during the free trial order. The monthly supply shipment consists of a 30 day supply of tooth whitening for $79.98 plus shipping and handling of $8.99. This will be shipped to you every month until you decide to cancel. To cancel call the support line at 1-866-360-1477 or email
support@luminousbrites.com
First name:
Last name:
Email:
Phone:
Shipping Address:
Shipping City:
Shipping State:
Select State
US Military (AE)
US Military (AP)
US Military (AA)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Shipping Zip Code:
PAYMENT INFORMATION
Card Type:
Visa
Mastercard
Credit Card:
Expiration:
Month
1 (Jan)
2 (Feb)
3 (Mar)
4 (Apr)
5 (May)
6 (Jun)
7 (Jul)
8 (Aug)
9 (Sep)
10 (Oct)
11 (Nov)
12 (Dec)
/
Year
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
CVV Code:
What's my CVV code?
I agree to the
Terms and Conditions
.
Refund and Exchange Policy
|
**Terms and Conditions
|
Privacy Policy
|
Contact Us
Copyright © 2008 LuminousBrites.com. All Rights Reserved. * These statements have not been reviewed by the Food and Drug Administration. ACTUAL PRODUCT IS NOT PICTURED. Aqua Fresh is not associated with and does not endorse this product in any way. Aqua Fresh is a trademark of it's owners. This product is not intended to diagnose, treat, cure, or prevent any disease.