ROADSIDE ASSISTANCE
 

FREE Roadside Assistance For 6 Months

  • Free Tyre Change or
  • Free Jumpstart or
  • Free Bringing of Fuel

 ( Within 20km radius from Hartbeespoort - Client only pays for fuel )

Register and Receive your FREE Membership & Sticker

 
  Please complete the fields below:
     
  DATE:
  NAME & SURNAME:
  IDENTITY NUMBER:
  PHYSICAL ADDRESS:
  INSURANCE COMPANY:
  INSURANCE POLICY NO:
  VEHICLE MAKE & MODEL:
  REGISTRATION NO:
  COLOUR:
  CELLPHONE:
  EMERGENCY NO:
  EMAIL ADDRESS:
  MEDICAL AID:
  MEDICAL AID NO:
     
   
  This membership is only valid if the Eagle sticker is displayed on the vehicle.
Towing rates will be calculated on AA Tariffs.
   
 
Security Check: