2. First Name
3. Last Name
5. Street Address*
7. Street Address 2
9. City
10. State
11. Zip
13. Phone*
15. Make of Golf Cart
16. Color of Golf Cart
18. Serial Number of Golf Cart
20. I have received, read, and understand the “Golf Cart Ordinance.” I acknowledge that I will assume all liability, and am fully responsible for the operation of the above cart and its passengers on the streets and roads in the City of Lincolnton. I also acknowledge that the City of Lincolnton, in providing this privilege, is in no way endorsing the operation of this cart on the streets and roads, and does not and will not assume and liability in the operation of the cart. I agree to indemnify and hold harmless the City of Lincolnton for any and all liability arising from the use of this golf cart. I also understand that the Lincolnton Police Department’s interpretation of all the rules and regulations are final. I will insure that the assigned proof of compliance will remain attached to the driver’s side of the cart at all times. I furthermore insure that I will obey all the rules and regulations set forth by the City of Lincolnton concerning the operation of a cart within the town limits.
22. Owner's Signature
24. Date
26. Notary Public (Official Seal)
28. Notary Public Signature
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30. 1. Receive an email copy of this form.
31. Email address

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32. Submit

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