White River Valley Antique Association

White River Valley Antique Association

Golf Cart Vehicle User Agreement Form

Name  ___________________________________________________________

Address  ________________________________________________________

City  ___________________________________________________________

State  _____   Zip Code  ________   Phone Number  _______________

Make ____________________________________________________________

Model __________________________   Year Manufactured ____________

Name of Insurance Company _______________________________________

Policy Number ____________________   Expiration Date ____________

Signature _______________________________________________________

Date ____________      Fee Paid $10.00   Check____      Cash ____

By signing this form I agree to abide by the posted rules for the use of golf carts, mules, gators, lawn tractors, or other motorized vehicles. Failure to obey the rules will result in the loss of the privilege to use them.

FILL OUT AND BRING TO SHOW WITH YOU!

DON'T FORGET YOUR CERTIFICATE OF INSURANCE.

THANK YOU.