MEMBERSHIP APPLICATION FORM

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PERSONAL DETAILS

Identification

MEMBERSHIP DETAILS

Membership type

A. Own compatible device @ $59.99 per monthB. Hitch dispatch provided device with data @ $99.99 per month

Membership commencement date*

Taxi registration number*

Credit/debit card*

Card number
Expiry date

Member of other taxi dispatch company in Bermuda:
YesNo

If yes, name(s)

AGREEMENT and SIGNATURE of MEMBER:
I confirm and understand that:
a) All information supplied above is true and correct;
b) In signing this application form I agree to abide by the conditions of membership as detailed on page 2 of this application form; and
c) Any termination of membership will be in accordance with the conditions of membership as detailed on page 2 of this application form.

*****THANK YOU FOR COMPLETING THIS APPLICATION FORM AND YOUR INTEREST IN HITCH DISPATCH*****

CONDITIONS OF MEMBERSHIP:
1. HITCH DISPATCH and the Member agree that HITCH DISPATCH will provide digital dispatch services to the Member for a period of twelve (12) consecutive months commencing on [commencement date];
2. HITCH DISPATCH and the Member agree that 0% commission is to be deducted by HITCH DISPATCH from all rides undertaken by the Member;
3. HITCH DISPATCH and the Member agree that HITCH DISPATCH will provide the Member with an option to renew for a further twelve (12) consecutive months upon completion of the initial twelve (12) months membership;
4. HITCH DISPATCH and the Member agree that, membership fees shall be deducted monthly with two (2) monthly payments initially upon registration and the remaining ten (10) monthly payments thereafter on the first day of each month (excluding public holidays where payments will fall to the next business day);
5. HITCH DISPATCH and the Member agree that, membership fees are to be deducted from monies earned on a monthly basis commencing on [commencement date];
6. HITCH DISPATCH and the Member, in the event of a negative ride balance, agree that membership fees due may be deducted from the Member’s credit or debit card;
7. HITCH DISPATCH and the Member agree that, all payments made to the Member by HITCH DISPATCH on any given Monday or Thursday (excluding public holidays where payments will fall to the next business day) are subject to a $1.00 EDI deposit fee;
8. The Member agrees that, HITCH DISPATCH shall have no responsibility for the replacement of a lost, stolen or damaged HITCH DISPATCH provided device; the Member agrees that it shall be responsible for the cost of $199.99 in respect of the replacement of a lost, stolen or damaged HITCH DISPATCH provided device; and
9. HITCH DISPATCH and the Member agree that, should either of HITCH DISPATCH or the Member request to terminate membership to HITCH DISPATCH each is to notify each other three (3) months in advance of requested termination date, subject to adherence to all applicable conditions noted at 1 – 8 above.

* all fields with a * are required