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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.
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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:
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Last Name:
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Address:
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City:
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State:
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Zipcode:
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Email:
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Phone:

Where should my cover be stored?
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Where is my Equipment?
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1111 S. Pleasant Valley Road, Westminster, MD 21158 | Phone: 410-848-2534 / 410-876-3535 | Email: Contact Us