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We are pleased to offer you a choice in the way you wish to be rewarded. Simply provide us with your current contact information, create a password and select your desired reward program.

*Required Fields

First Name:* Last Name:*  
Address:* City:*  
State:* Country:*  
Zip Code:*      
Mobile #:* Phone #:*  
Email:* Confirm Email:*
Create Password:*    Confirm Password:*
Promo Code:         

Please select your desired reward program:

Reward Program:* Reward Program Member #:*      



Vehicle Information:

License Plate #:* Vehicle Make:*
(i.e. Ford, Dodge, Toyota)

 I have read and agree to the Terms & Conditions and Privacy Policy and understand that by joining the Lex Brodie’s Tires Rewards Program, I am also signing up with the email program.