Pay Your Water/Sewer Bill Online

Golf Cart Registration Form

Golf Cart Owner Registration

Town of Stedman, North Carolina

 

Golf Cart Owner’s name(s): ______________________________________________________

 

Owner’s Physical Address: _____________________________________________________

 

City/Town: _________________________   State: ____________   Zip: _________________

 

Owner’s Mailing Address: ______________________________________________________

 

City/Town: _________________________   State: ____________   Zip: _________________

 

Owner’s Telephone No. Daytime: (_____)____________ Night time: (_____)______________

 

Owner’s Driver’s License Number: ________________________ State: __________________

 

Make of Golf Cart (Mfg): _______________________________________________________

 

Color of Golf Cart: ________________________  Model (Year): _______________________

 

Serial Number of Golf Cart: ____________________________________________________

 

Liability Insurance (Company, Policy Number, Insured): ________________________________

 

___________________________________________________________________________

*** Please Attach Copies of Liability Insurance AND Driver’s License ***

 

I have received, read and understood the “Golf Cart Ordinance”. I have paid the inspection fee for the above cart. I acknowledge that I will assume all liability, and am fully responsible for the operation of the above cart on the streets and public vehicular areas in the Town of Stedman. I also acknowledge that the Town of Stedman, in providing this privilege, is in no way endorsing the operation of this cart on the streets and public vehicular areas, and does not and will not assume any liability in the operation of the cart.  I agree to indemnify and hold harmless the Town of Stedman for any and all liability arising from the use of this golf cart. I will insure that the permit sticker and the Warning and Disclaimer of Liability will remain attached to the cart in the prescribed manner at all times.  I further agree that I will obey all the rules and regulations set forth by the Town of Stedman concerning the operation of a cart within town limits.

 

            _______________________________                      __________________________

                        Owner’s Signature                                                                  Date

 

 

© Town of Stedman, North Carolina. All Rights Reserved.