Unlimited Car Wash Enrollment Application

VEHICLE AND PACKAGE INFORMATION

Store # _____________

*Complete and submit to a cashier at any participating Holiday. Visit holidaystationstores.com and click on Wash Pass icon for locations.

*Make: _________________________________ *Model:_____________________________ *Check one:

The WORKS Package; $29.99 per month plus tax

License Plate #: ______________________

The BASIC Package; $19.99 per month plus tax

APPLICANT INFORMATION (please print)

*Name:____________________________________________________________________________________________________________ *Address: __________________________________________________________________________________________________________ *City: _____________________________________________________ *State:________________ *Zip Code: *Day Phone: (
) _____________________________________ Evening Phone: ( _____________________

) ______________________________

Email Address: ______________________________________________________________________________________________________ BILLING INFORMATION

*Card Holder Name: _________________________________________________________________________________________________ *Credit/Debit Card (check one):

Holiday Visa MasterCard Amex Discover

*Credit Card #: ________________________________________________________________ *Expiration Date: ____________________

Holiday Associate, please verify: Employee Initials ___________

TOTAL MONTHLY MEMBERSHIP FEE

________________ Applicable state and local taxes are not indicated here.

TERMS, CONDITIONS, PURCHASE AGREEMENT

Membership is per vehicle and for personal use only. Taxis, limos and oTher professional vehicles are prohibiTed. Membership is not valid for vehicles that cannot fit on the conveyor or are unable to ride through the tunnel. Membership fee will be automatically billed to your credit or debit card each month for the services selected plus all necessary state and local taxes. Each month thereafter, for the term of the agreement, the monthly payment will be billed on the day corresponding to the commencement date. This program cannot be combined with any other programs or discounts including, but not limited to Corporate Account Discounts, Prepaid Wash Sessions, and/or Coupons. Holiday Stationstores reserve the right to modify or cancel this program at any time without notice. Although this is an unlimited use membership, the car wash equipment is mechanical and may occasionally be unavailable due to repairs/maintenance or weather-related events. Holiday Stationstores also reserves the right to suspend car wash privileges. Membership is only transferable upon purchase of a new or different vehicle and upon official notice to Holiday Companies. To cancel your membership in this program contact Holiday Companies by doing one of the following: Call (952) 830-1616 Email unlimitedwashclub@holidaycompanies.com Write Holiday Companies Wash Pass Unlimited Car Wash 4567 American Blvd W Bloomington, MN 55437 Note: No refunds or credits will be given for partial periods/months.

I agree to the terms and conditions stated above:

*Applicant Signature: ___________________________________________________________ *Date: _____________________________

Holiday Associate, please verify: Employee Initials ___________

Questions or comments? Call: (952) 830-1616 Email: unlimitedwashclub@holidaycompanies.com

FOR INTERNAL AND OFFICE USE ONLY

Club Membership Number: ______________________________

Find out more at holidaystationstores.com

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