Monthly Membership Plan (Credit or Debit Card Required for Monthly Payments)

Items with * are required information.

Member name*

Phone number*

Address*

City*

State*

ZIP*

Birth date

Email*

Membership Type*
XpressBestPremierPremier PlusFamily MembershipFamily Membership Plus

Vehicle make*

Model*

Year*

Licence #*

Only for Family Memberships

Vehicle make, Car #2

Model, Car #2

Year, Car #2

Licence #, Car #2

Vehicle make, Car #3

Model, Car #3

Year, Car #3

Licence #, Car #3

Automatic Funds Transfer: Customer Authorizes Elevon Payment Service’s pre-authorized payments by electronic funds transfer.I hereby authorize R and R Auto Spa, dba Mike’s Auto Spa, LLC to initiate Debit/Credit charges for my monthly membership for the amountlisted on this application.

Name*

Authorized amount*

Date*

I confirm that this form is valid without my signature and that I will complete my payment by phone or in person.

Spam Prevention

Terms & Conditions

1. The company promises to deliver the agreed upon services as advertised in the company’s marketing material at any Mike’s Auto Spa location whenever the customer or customer’s agent presents the authorized vehicle for servicing providing the account number stays current and the carwash is open for business.

2. Customer may not transfer a registered license plate to another vehicle. If this is found to be occurring, the membership will be canceled with no refunds to be given.

3. If checking debit is the customer’s chosen payment method, the company’s bank, Bank of the West, will debit the customer’s checking account for the monthly service fee and those other purchases the customer or customer’s agent has signed for.

4. An agent is defined as any person driving the authorized vehicle presenting the customer’s personal license plate (that is on file) to the company’s representative as authorization to charge on the customer’s account. Any person authorized to drive the vehicle with the license plate on file may bring the vehicle to the car wash.

5. The customer agrees to give company 30 notice for termination of an account, as NO REFUNDS will be given.

6. The customer agrees to pay 11.2% interest per month on any unpaid balance over 30 days.

7. The customer agrees to reimburse the company for insufficient funds charges plus an additional $15.00 service charge.

8. The customer agrees to hold the Company harmless in cases where the company’s services have closed early or failed to open for any reason.

9. The Company retains the right to terminate the membership for any reason and revoke all charge privileges so long as the company provides the customer 30 days notice of said termination and rebates prorated portion of unused monthly Service.

10. Customer may cancel by filling out a cancellation form 30 days of cancellation date. A Form may be mailed, emailed or faxed to you if needed. Please call 720-473-5656 to request form or email us at info@MikesAutoSpaCarWash.com.

11. Customer may not extend their membership plan to any commercial vehicle (Vehicles belonging to businesses need to be set up under fleet membership accounts.) If a customer is found using their membership for commercial vehicles, their membership will be canceled with no refunds to be given.

12. The customer agrees to keep their personal credit information up to date with Mike’s Auto Spa or their membership will be canceled.

13. A Customer is required to update Mike’s Auto Spa with a license plate number change.