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You can become a WelGard® member immediately, by completing the form below and paying online with your credit/debit card. Welcome aboard!

(To Renew your WelGard® membership plan, click here.)

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How Did You Hear About Us?*
Customer Information
Name*
First Last
Address for the Property Being Covered*
All fields are required.

Street Address City State / Province / Region ZIP / Postal Code
County*
Phone*
Hidden
Email (OLD)
Email Address*
Well Permit # (if known)
How Deep Is Your Well?*
- Less than 500 ft
- More than 500 ft
- Don't know

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Are there any obstructions to the well?
- Yes
- No
Any well problems in the past 12 months?
- Yes
- No
Any loss, low or changing water pressure in the past 12 months?
- Yes
- No
Is this a new/replacement well?
- Yes
- No
Have you ever run out of water?
- Yes
- No
Any work performed on the well in past year?
- Yes
- No
Expect to sell property in next 12 months?
- Yes
- No
Any water quality concerns?
- Yes
- No
Explain any "Yes" answers here

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Purchase WelGard Plan
WelGard Warranty
- Prepaid - $499.00 Yearly
- Monthly Payment - $45.00
WelGard Warranty
- Prepaid - $649.00 Yearly
- Monthly Payment - $58.00
Add Ons
Add Inspection/Yield Testing and Water Potability testing
Price:
Selected Options
- Inspection/Yield Testing - $250.00 (This waives the 30 day waiting period.)
- Water Potability Testing – for Bacteria, Nitrates, pH, Turbidity, and Sand - $150.00
Total
$0.00
Terms and Conditons*
- I agree to the terms and conditions
Billing Address
If different from property address.

Street Address Address Line 2 City State ZIP Code
Credit Card
Card Details
Cardholder Name
Protection Plan Services
WelGard® Protection Plan Services: Includes the repair or replacement of (1.) a well yielding less than 1 gallon per minute (drilling a new well), (2.) all well components up to and including the pressure tank, including replacement of a defective well cap, water and electric line from the well to the house, well pump and connections, valves, fittings and adapters as determined by Well Guardian Corporation (WGC). This protection is subject to a 30-day waiting period, which begins from the Effective Date noted above. This waiting period will be waived if the customer chooses to purchase the Initial Set Up and Testing for an optional fee, as selected above in Section 3. If selected, WGC will arrange for (1.) an annual visual inspection of the well, well cap, pressure gauges, well tank and testing of the functioning of the pump as possible, and (2.) water safety testing including bacterial analysis, Nitrates, pH, sand and turbidity. Call in orders for these services are accepted and scheduled at no additional cost.
NO RISK 30-DAY REFUND PERIOD
Certification
Certification: Customer certifies that the above information is correct to the best of their (my/our) knowledge, that the subject well is for residential use only, and is in good working order. Customer may cancel this Agreement during the 30 day recission period, whereupon customer will receive a refund of fees paid, excluding initial set up and testing fees and other costs incurred. Customer understands that WGC will not be responsible for normal wear and tear of equipment, including well or equipment failure, that may occur during their testing in order to accept this Application. Customer has read the description of Services, Terms, Conditions and Limitations on the reverse side. WGC agrees to automatically renew this Agreement, only with customer full and timely payment in amounts billed by WGC for future years. This Agreement is NOT valid without current customer payment, and WGC acceptance of payment for options requiring the lapse of the 30-day waiting period and inspection does not automatically qualify customer for the benefits until inspection and/or 30-day waiting period is complete.
Phone
This field is for validation purposes and should be left unchanged.

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Realtors

Got clients dreaming about a home with a residential well? No problem. Set their mind at ease with an inspection and potability testing.

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NEW! Weekend Service

WelGard® Protection, even on the weekends.

Test Sunday - Know Monday. Inspections, potability, and yield. Call (410) 630-6900.

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WelGard®: Protecting Your Well Today From Tomorrow’s Problems

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