Customer Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Alt Phone

(###)

###

####

Services Desired *

Check all that apply

Maximus Detail Package

Interior Detail

Exterior Detail

Engine Detail (Customers own risk)

Hand Wash

Other

Legal Agreement *

I hereby authorize the detailing work herein set forth to be done along with the necessary material and agree that you are not responsible for loss or damage to vehicle or articles left in vehicle for any form of cleaning, in case of fire, theft or any other cause beyond your control or for any delay caused by unavailability of special cleanse needed. I hereby grant you and/your employees permission to operate the vehicle herein described on streets for the purpose of dropping off/picking up.

Yes, I agree to everything above.

Date *

MM

DD

YYYY