Choose your perfect service

You are signing up for which CoastLife Pools Service?*

Type of Pool*

Salt Pool
Chlorine Pool

Primary Contact*

First Last

Phone*

Email*

Secondary Contact*

First Last

Phone*

Email*

Phone

How do you prefer to be contacted?*

Email
Text Messages
Phone

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Gate Code (if applicable)

Chemical Delivery Location*

Does not apply

*Chemicals will be delivered to pool equipment location, unless other wise advised.

Security Gate

I will Notify Security Gate
Not Applicable

Please Notify your Security Gate with our Company information for us to gain access.

Do you prefer to receive your invoices electronically via email or would you rather have a paper copy mailed?*

Email
Paper

Payment Authorization Form For Monthly Pool Service*

I read and approved authorization - An email will follow to fill out payment information to keep on file.

The customer agrees to store their payment information (ACH or credit card details) with CoastLife Pools. The customer authorizes CoastLife Pools to automatically charge their chosen payment method for monthly pool service, salt and conditioner charges throughout the year as part of our service. Payments will be processed on the 1st of each month. CoastLife Pools will send an email for the customer to choose between ACH (Automated Clearing House, for direct bank transfers) or a credit card.

If while servicing your pool or equipment, CoastLife notices a minor repair or part replacement not to exceed $100.00, which is necessary for the efficient operation of your pool or pool equipment, we would appreciate having your authorization to take care of the situation before it develops into a major repair. Do you approve repairs under 100.00?*

Yes, Please charge with payment method on file
Yes, I will pay Separately
No, Call for approval
If choosing an amount over $100.00, please indicate maximum not to exceed below

What source of water do you use to fill your pool?*

Well water (never fill a pool with unfiltered well water)
Water softener
City water

Pool Safety - It is a state law that Main Drains should be replaced every 7 years. When were your Main Drain(s) last replaced?

Within the past 7 years
Never
Not sure

Pool Filter Cartridge - Your pool filter is the heartbeat for healthy pool operations. When was your filter cartridge replaced last?*

Under a year
More than a year ago
Not sure

Do you have any special requests or anything we might need to know about your pool?

How did you find us?*

Would you like a to request a free quote on any equipment upgrades? For example variable pump, smart phone app, other upgrades or items. Did you know you can save up to 90% of your energy costs by investing in a variable speed pump. Ask us today.*

Yes, please contact me to discuss my options
Not at this time

Are there any pool repairs that you are aware of that need addressed at this time?*

I have read and agree to CoastLife Pool & Spa's Services and Policies.*

Yes

Please see the Services & Policies WebLink:
Pool ChemXpress On-Demand Service
Pool Chemical Only Service
Standard Pool Service
ALL-IN Pool Service

DISCLAIMER

If invoice is not paid when due, interest will accrue at the rate of 2% 10 / 31 days (20% annum) or $15 per month whichever is higher. If after the due date the account is placed in the hands of an attorney or collection agency, Customer shall be liable for all costs of collection, including legal fees, whether or not said matter is brought to trial, and for all trial proceedings including levy, execution, garnishment or any appeal. CANCELATION POLICY: Service Client must submit a 30-day cancelation notice prior to canceling monthly service in any case or pay a monthly service fee equal to their monthly rate to terminate service prior. CoastLife Pools reserves the right to cancel a client at any time for any legal reason without incurring legal liability. Last Invoices will be sent pro-rated for pool service, conditioner charges and any salt charges or various repairs. The account will not be officially closed until such time as the payments are made in full.

Section Break

Email

This field is for validation purposes and should be left unchanged.

Choose your perfect service

DISCLAIMER

Section Break

Billing popup