Complete all required information below and submit to enter:

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* First name

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* Last name

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* Job Title

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* How do you plan to use the boot?

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* Employer

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* Employer location

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* Shipping Information
Canada addresses only. If you have a USA address, please visit haixusa.com/100

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* Contact Information

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* Boot preference

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* Boot size (for XR23 & XR26 selection)
Runs true-to-size based on your athletic shoe size.

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* Boot size (for Protector Ultra Signal Red selection)
Runs one half size larger based on your athletic shoe size.

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* Width
XR23/XR26 width runs narrow
Protector Red width runs true-to-size

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* What footwear do you currently wear?

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* How long does your current footwear last?

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* Instructor license? 

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* Do you have your own professional social channel as a social media influencer or educator? (e.g. Facebook, YouTube, Instagram)

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