Customer First name:

Customer Last name:

Street Address

Town / City

Province

Postal Code

Phone

Email

Make Of Boat

Boat Model Name

Year

Length

Vehicle Identification Number

Dealer Name

Business Office Manager

Dealer Street Address

Dealer Town / City

Dealer Province

Dealer Postal Code

Dealer Phone

Agreement Period

BoatFix 1 Year Plan ($30/month) 6 Months Free

BoatFix 2 Year Plan ($27/month) 1 Year Free

BoatFix 3 Year Plan ($25/month) 1 Year Free

Agreement Purchase Date (YYYY-MM-DD)

Agreement Auto-Renewal Date (YYYY-MM-DD)

Terms and conditions

I have read and agree to the terms and conditions

04 // LET'S TALK

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Billing Information.

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Step 2. Select Your BoatFix Plan

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