Collision Damage Waiver Subscription Form

Name*
This should be the name of the Account Owner (the person who is responsible for billing against the account)

Email Address*
This should be the email address of the person named above and which is used for logging into the Co-wheels Booking Platform

Account Name*
This should be the name you gave to your account ( in the Co-wheels Booking Platform ) that you wish the Collision Damage Waiver to be applied against

Level of Cover Required
In the majority of cases it is expected that this will be the first option however if you have multiple drivers on your account please consider whether one of the higher levels is applicable.

If number of drivers should change then the responsibility is with the Account Owner to ensure the appropriate level of cover is applied by contacting Customer Support

Agreement to Terms & Conditions*
Collision Damage Waiver is offered on a minimum term of 12 months charged at the monthly rate as selected by the member. Full terms and conditions regarding Collision Damage Waiver can be viewed here;

http://www.co-wheels.org.uk/what_are_your_full_terms_and_conditions

Please check the box to agree to the Terms & Conditions for Collision Damage Waiver

Send me a copy of my responses

Email address