Customer Contact Information

Customer Name*:

Contact Number*:

Email*:

Customer Address

Address*:

City*:

Postal Code*:

Vehicle Information

Make*:

Model*:

Year*:

Colour*:

License Plate #*:

Which Pass You Would Like to Purchase?

Express: $14.99+tax/monthPlus: $17.99+tax/monthProtect: $20.99+tax/monthExtreme: $26.99+tax/month

Terms and Conditions

Please check that you have read the following terms

I acknowledge my credit card will be charged each month on the anniversary date. No statements are provided.

I can cancel my membership at any time. A cancellation form must be completed. Members must provide 4 business days notice for cancellation or upgrades.

I acknowledge membership is only valid for the vehicle listed above and agree to show my membership card to attendant before entering the wash if requested. Violation will result in cancellation.

No credit of refund will be given for partial use in a month.

Replacement cards are $10.00 each.

If membership is cancelled for any reason a $50 reactivation fee will apply.

Members may upgrade or change plans on next billing cycle.

I acknowledge that this membership is only valid at location purchased and a security tag may be affixed to my windshield.

Valet Car Wash reserves the right to cancel, amend or change club program from time to time as it deems necessary.

Club membership provides members with unlimited exterior washes (not to exceed 2 per day) for each 30-day pre-paid period. Excess abuse may result in cancellation.

Offer is valid during business hours and may not be available due to hour changes, weather, maintenance or breakdowns.

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