Electric Golf Cart Registration

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110 Train St E, PO Box 489, Orting, WA 98360
Phone: 360.893.2219 ext. 120 * Fax: 360.893.6809
Email:
Website:
ELECTRIC GOLF CART REGISTRATION
[ ] NEW
[ ] RENEWAL
LAST NAME: ___________________________, FIRST NAME: ______________________ MI: ____
MAILING ADDRESS: ________________________________________________________________
PHYSICAL ADDRESS: _______________________________________________________________
PHONE: _______________________________
EMAIL: __________________________________
GOLF CART YEAR: ___________ MAKE/MODEL: _______________________________________
SERIAL#: _______________________________________________
ANNUAL REGISTRATION FEE
: $15.00
(must be paid in January of every calendar year)
My initials and signature below verifies that I:
Have received the City Ordinance #903, Municipal Code 7-8 and RCW 46.08.175 governing
Golf Cart Zones have reviewed the documents and understand them. _____
Initials
Relieve the City of all liability regarding my electric golf cart and its operation. _____
Initials
Understand that the City is neither inspecting my electric golf cart nor guaranteeing its
condition or safety. But understand that my electric golf cart must be equipped with
reflectors, seatbelts and rearview mirrors. _____
Initials
Must have a valid Washington State Drivers License and/or anyone who drives my registered
Golf Cart and will obey the rules of the road knowing that I or a licensed driver driving my
electric golf cart can receive a violation. _____
Initials
Am responsible to maintain my annual registration every January. _____
Initials
My signature indicates that I have given the proper information in regards to my electric golf cart that I
own. By signing below verifies that I understand all that is required to operate my electric golf cart.
Signature: _____________________________________________
Date: ___/___/___
Official Use Only:
City Issued Electric Golf Cart Registration Number: _______
Tab Year: ________
Amount Paid: _________ Check / Cash / Debit / Credit
Receipt #: ___________
001.322.90.11.00
Updated 1/5/2016

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