By signing and clicking Submit I fully acknowledge that I have read, understood and accept the terms and conditions of Mobility Drive Plan Membership. I am aware that for Mobility Drive (Pty) Ltd. to provide me with a Courtesy Car, the covered vehicle, as captured on this Submission Form, must experience a Mechanical/Electrical Breakdown or require a Scheduled Manufacturer Service only. I hereby acknowledge that the Administrator shall not be bound by any undertaking, expressed or otherwise, from any person other than that which is stated within the Mobility Drive Terms and Conditions. I further acknowledge that I am aware that a fuel deposit is required by the supplier, which can be refunded to me upon returning the vehicle with a full tank of fuel, less any toll fees and/or fees or costs as a result of damage/s to the vehicle. I accept that Mobility Drive (Pty) Ltd. reserves the right to amend any incorrect information on this Submission Form and to notify me of these amendments. Further to the above, I also understand that no Courtesy Car will be made available to me if the applicable Monthly or Annual payment has not been received by Mobility Drive. I hereby instruct/authorise Mobility Drive (Pty) Ltd. to deduct the applicable monthly/annual debit from my bank account as provided by me herewith, and as per the payment frequency chosen by me.