Email address *
Please let us know how much you would like your gift card for?
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Specific GC amount:
Would you like it gift wrapped?
Would you like to add PURE swag to the GC?
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Phone Number *
Billing Address (please include street, unit number, city, province/state, and postal code/zip) *
Credit Card Number *
Expiration Date *
CVV Security Code (3 digit code on back of card) *
I understand that by submitting this form, I authorize PURE Gym & Juicery (1081310 BC LTd.) to charge my credit card for my order.
We will call you when ready for pick up.
Thank you for supporting our small business, we appreciate you!
Thank you!
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