Gallagher Pools and Spas service authorization

Authorization Form

**Please note that if you have not already scheduled your opening date with us filling out this form will not guarentee you a date.

Please fill in your information below.
« = Required Field

Authorization: I authorize Gallagher Pools and Spas to perform any minor repairs or service during my opening that they may find need to be performed. I do not authorize Gallagher Pools and Spas to perform any minor repairs or services during my opening day. I understand that by checking this any extras will require a return trip which will require and extra labor fee. Note: If a return trip is needed to perform these repairs/services an extra labor fee will be charged.«
Explanation of Services: I have read and understand the explanation of services listed on the spring Services page. I have NOT read or do not understand the explanation of services listed on the spring Services page. .«
Mesh Chemicals in March (pools opened in April and May): I authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in March I do not authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in March. I understand that the condition of my water will suffer with out additional chemicals. I do not have a Mesh Cover. .«
Mesh Chemicals in April (Pools opened in May and June): I authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in April I do not authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in April. I understand that the condition of my water will suffer with out additional chemicals. I do not have a Mesh Cover. .«
Mesh Chemicals in May (Pools opened in June): I authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in May I do not authorize Gallagher Pools and Spas to add chemicals beneath my mesh cover in May. I understand that the condition of my water will suffer with out additional chemicals. I do not have a Mesh Cover. .«
Vacuuming: I authorize Gallagher Pools and Spas to vacuum my pool for $85.00 per hour. I am aware that this may require more than one visit, billed seperately each visit I do not authorize Gallagher Pools and Spas to vacuum my pool for $85.00 per hour. I will do all Vacuuming myself. Note: If a return trip is needed to perform these repairs/services an extra labor fee will be charged.«
Pumping water off cover: I am aware that if there is any water on top of my cover, I will be charged $150.00 per hour to remove it. I do not understand and will call the office to confirm.«
First Name: «	Last Name: «
Address: «
City: «	State: «	Zipcode: «
Email: «	Phone:
Where should my cover be stored? «
Where is my Equipment? «
Credit Card Number «
Expiration Date «
Security Code (three digit number on back) «
Amount to charge (Chemical Total recommended, $200 minimum)" $

1111 S. Pleasant Valley Road, Westminster, MD 21158 | Phone: 410-848-2534 / 410-876-3535 | Email: Contact Us