To sign up for a Pit Pass or to change information on a current Pit Pass, just print and fill out this form and take it to any Pit Stop location. It’s that easy! Name: __________________________________________________________________________________________ Address: ________________________________________________________________________________________ City: ____________________________________________________________________________________________ State: _______________________________________ Zip: _____________________________________________ Phone (H): ___________________________________ (W): _____________________________________________ Email: __________________________________________________________________________________________ Date of Birth: _______________________________________________ Sex M: ___________ F: ______________ Vehicle - Year: _____________ Make: _____________________ Model: _______________________________ PITPASS Rewards Tag Terms & Conditions: By applying for and using the PITPASS Rewards Tag, the participant agrees to be bound by the current PITPASS Rewards terms and conditions, a copy of which may be obtained at any participating Pit Stop convenience store. Participants must complete and submit the PITPASS application in order to receive and use the PITPASS Rewards Tag. Points can be earned at participating Pit Stop locations and premises of PITPASS partners for qualifying purchases as specified by Pit Stop (using approved methods of payment). PIT- PASS participants will not accumulate points for any commercial purchases, including Pit Stop fleet purchases, major oil companies, fleet cards, or any other form of payment or company checks, i.e. Comdata or Comchecks. Points will not be accumulated for lottery tickets, money orders, money transfers, or third party services. A valid PITPASS Rewards Tag must be presented at the time of purchase in order to receive reward points. Points will not be awarded without a valid tag or for previous purchases. Only one PITPASS Rewards Tag per customer. Points may not be combined or transferred between participants. PITPASS Rewards Coupons may be redeemed at any participating Pit Stop location, unless otherwise specified. Rewards coupons must not be expired, illegible, altered or damaged. Duplicates of original Rewards coupons will not be accepted. Validation of participants’ details may be required in order to redeem reward. Lost, stolen, or damaged coupons will not be replaced. Pit Stop may substitute any rewards or prizes for those of a comparable value without notice. Pit Stop is not responsible for lost, stolen, or damaged tags or unredeemed points; however, these may be replaced at Pit Stop’s discretion. Pit Stop is not responsible for any error resulting from computer hardware, software error, or fraud. All PITPASS Rewards Tags are licensed to Pit Stop and remain the property of Pit Stop convenience stores. Pit Stop may cancel any PITPASS Rewards Tag at any time at its sole discretion. Pit Stop may amend the PITPASS Rewards Terms and Conditions or any specific PITPASS Rewards promotion at any time. It is the participant’s obligation to keep informed of the latest PITPASS Rewards Terms and Conditions. Pit Stop reserves the right to terminate the PITPASS Rewards Program at any, or all, participating locations at any time without prior notice. Employees of Pit Stop and their immediate families are not eligible to participate in the program. Personal information obtained on this application will not in any way be given or sold to any other party. You will never be contacted by anyone other than an individual from Pit Stop Convenience Stores or Woodfin Heating, Inc.