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(Complete this form only if you want to revoke the agreement)

- At Euregiohunt, Wijnweg 1, 6273 ND Ingber / The Netherlands, [email protected]:

- I / We (*) share / share (*) hereby / rescind / cancel our agreement on the sale of the following goods / delivery of the following service (*) (*)

- Ordered on (*) / Received on (*)

- Name / Name of consumer (s)

- Consumer Address (s)

- Signature of consumer (s) [only when this form is submitted on paper]

- Date

(*) Cross out what is not applicable.