Customer Contact Information

Customer Name*:

Contact Number*:

Email*:

Customer Address

Address*:

City*:

Postal Code*:

Vehicle Information

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Model*:

Year*:

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License Plate #*:

Which Pass You Would Like to Purchase?

Express: $17.99+tax/monthPlus: $21.99+tax/monthProtect: $25.99+tax/monthExtreme: $29.99+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.

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

Replacement RFID Tags 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 will be affixed to my windshield. Tampering with or removal will result in cancellation.

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

We recommend washing once per week. Excess abuse may result in cancellation. Maximum one wash per day.

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

I confirm that this vehicle listed is not used as a Taxi, Limo, Uber, Lyft or for any other ride-sharing service.

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