EDIT: Looks like this is dead already.
You gotta love the slogan for this free Curamin pain reliever sample. Got Pain? Try Curamin! When you think about it, when you’re in pain truly is the perfect time to try a pain reliever, as opposed to when you’re hungry or afflicted with hiccups. Glad they spelled that out for us.
I didn’t get a confirmation message (it redirected me back to the homepage), but when I tried to sign up a second time it told me I’d already registered. So I think the form is working.