Multiple Vehicles Membership Registration

All Plans Include:

Live Dispatch: Available 7 days a week, 6am-9pm for any service need.

Quick Response Time: We prioritize prompt, reliable service.

Comprehensive Services: Including tire repair and replacement, spare tire, car lockout, jump-starts, and fuel delivery.

Personal Information

Name*

First NameLast Name

E-mail*

example@example.com

Phone Number:*

1st Vehicle Information*

Color, Year, Make, and Model

Additional 1st vehicle details (Optional)

Example: Tire size, custom modifications, other details.

2nd Vehicle Information*

Color, Year, Make, and Model

Additional 2nd vehicle details (Optional)

Example: Tire size, custom modifications, other details.

Do you want to add a Third vehicle?

YesNo

3rd Vehicle Information

Color, Year, Make, and Model

Additional 3rd vehicle details (Optional)

Example: Tire size, custom modifications, other details.

My Products*

Basic Membership 2 Vehicles4 Service calls per year, per vehicle. 30 miles service area radius.

$19.98 for each month

Basic Membership 3 Vehicles4 Service calls per year, per vehicle. 30 miles service area radius.

$29.97 for each month

Premium Membership 2 vehicles5 Service calls per year, per vehicle. 40 miles service area radius.

$33.98 for each month

Premium Membership 3 vehicles5 Service calls per year, per vehicle. 40 miles service area radius.

$50.97 for each month

Elite Membership 2 vehicles6 Service calls per year, per vehicle. 60 miles service area radius. *Priority Scheduling

$49.98 for each month

Elite Membership 3 vehicles6 Service calls per year, per vehicle. 60 miles service area radius. *Priority Scheduling

$74.97 for each month

Email

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

By clicking the "Submit" button you agree to the Terms and Conditions and confirm that your vehicles meet the elegibility criteria.

Once you submit your application, your payment will be securely processed. After we receive your payment, we will contact you to finalize your Membership and it will be active within 72 hours. Thank you!

Welcome to Tire Assist Club