Maintenance Plan Sign-Up

Before beginning, which of these will your servicing zip code?

If your zip isn't listed, select "other" and continue to fill out the rest. We may still cover you!

Name

First NameLast Name

Service address

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Mailing address (if different)

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Brief Well Location/Gate Codes

When would you like the starting date to be?

Date

Routine Maintenance Only (Not Insurance/Guarantee): Explicit text stating that the plan is for routine inspection/testing only and is not a home warranty, insurance policy, or guarantee of equipment longevity.
Exclusions of Coverage: Clear list excluding replacement parts, major labor, pump pulling, drop pipe, re-drilling, subterranean water table depletion, sand/sediment infiltration, pre-existing defects, and Acts of God (freezes, lightning, power surges, pest damage).
Pre-Existing & Aging Equipment Waiver: Specific waiver stating Athens Water Well LLC is not liable for failures, pipe fractures, electrical burnouts, or tank bladder ruptures that occur during or immediately following normal inspection testing due to pre-existing wear, age, or corrosion.
Subterranean & Water Table Limitation: Statement assuming no liability for environmental or geological changes in water quality, flow rate, or static water level.
Limitation of Liability Cap: Clause capping your total maximum liability under Texas law to the total amount paid by the customer under the agreement over the preceding 12-month period.

By submitting my payment details below, I authorize Athens Water Well LLC to automatically charge my credit card, debit card, or ACH account on file for $250.00 annually or $25.00 monthly based on my selected plan. I understand this authorization will remain in effect until canceled.

This agreement automatically renews for successive 12-month terms unless canceled with 30 days written or digital notice. Early cancellation after an annual inspection has been completed will result in a charge for the remaining balance of the annual plan fee.

Recurring Billing: You authorize Athens Water Well LLC to charge your stored payment card on a recurring basis for the plan rate selected (Monthly or Annual) on or near the same day of each billing cycle for the duration of your Well Health Plan agreement.
Card on File for Approved Services: You further authorize Athens Water Well LLC to charge your card on file for any additional repair services, parts, or maintenance work that you explicitly authorize in writing or via text message.
Cancellation Policy: You may cancel this authorization and your maintenance agreement at any time by providing a 30-day written notice via email to billing@athenswaterwell.com or by calling (903) 477-3076. Charges accrued prior to the effective cancellation date remain due and payable.
Payment Updates: If your card details change or a payment is declined, you agree to provide updated card information promptly to maintain continuous service coverage.

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$250.00 for each year

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Maintenance Plan Sign-Up

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