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JOIN

To sign up for your Club Card, complete and submit (via fax, mail or personal delivery) the form that follows:

Date:
First Name:     Last Name:  
Billing Address : City:
State: Zip:
Phone: Email:
License Plate #:    
Make of Vehicle : Model:
EXPRESS
Normal per Visit Cost $5.00
WHEEL DEAL
Normal per Visit Cost $7.00
DELUXE
Normal per Visit Cost $10.00
PREMIUM
Normal per Visit Cost $15.00
ULTIMATE
Normal per Visit Cost $25.00
Credit Card Information:
Payment Method: Visa     Mastercard    American Express    Discover
Credit Card #: Numbers only, no spaces please.
CVV2#
This is a 3-4 digit #, now required by all card issuers. Found on back of card for Visa/MC/Discover & a 4 digit number on front of card for Amex
   Expiration Date:
Your card will be billed in U.S.$. This information will be sent encrypted to our secure server.
Terms of Offer:
* Includes Unlimited Washes   (1 vehicle per day - monitored by license plate#)
* Credit Card will be charged on the 1st of each month for your Unlimited Choice + any upgrades purchased at the Car wash Auto Teller Terminal
* Lake Geneva Ultimate Car Wash or the Wash Customer reserves the right to cancel this contract at any time/for any reason.
* Price Subject to change without notice
© Copyright 2006 by Lake Geneva Ultimate Car Wash & Web Centers of America, Inc.