Golf Cart Registration/Renewal Application

(If Renewal) Enter Plate # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Upload Current Golf Card Safety Class Test Results {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

GOLF CART SAFETY DISCOUNT: If you have attended the Golf Cart Safety, Rules & Regulations Class (online).You required to upload a copy of your Golf Cart Safety test score in order to receive the discount.

*Note: Discounts are ONLY valid for the year in which the class was taken and may ONLY be applied to golf carts registered to the holder of the card.

Name of Rental Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Business Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Tax ID# {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Emergency Contact Person (after hours) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Owner/Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Co-Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Home Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Cell Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Other Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Emerald Isle address where golf cart is kept: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

If you are requesting a waiver of the registration fee based on the handicapped status of the Owner/Applicant, you are required to provide the following information. Please note that the Placard must be issued to the person listed as the Owner/Applicant on this application.

Handicapped Placard # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

You must enter a current, valid handicapped placard number

Upload Current DMV Registration for Handicap Placard (Required) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Golf Cart Serial # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

If your golf cart has a 16-digit serial number, it is a VIN and must be registered as a Low-Speed Vehicle with the State of North Carolina

Make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Year: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Color: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Applications with incomplete or missing information will not be processed. EITO 11-44 requires that your golf cart be covered under an auto liability policy with the same minimum coverage as is required for an automobile in North Carolina. You are required to furnish a copy of your insurance policy as proof of compliance prior to receiving your registration.

Insurance Company: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Policy Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Insurance Company Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Agent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Upload Proof of Insurance Policy {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

I certify under penalty of perjury that this vehicle is insured with the company listed above and that I will maintain the required liability insurance throughout the registration period. I further understand that I am required to notify the town of any changes in insurance carriers. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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In order to process your application, you must read and indicate that you agree to abide by each of the following as a condition of your registration:

I acknowledge that registration of my golf cart with the Town of Emerald Isle is a privilege that may be revoked at any time for violations of the rules and regulations outlined below. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

I acknowledge that I am responsible for all operators/passengers of my golf cart, whether I am present or not and that it is my responsibility to ensure that any operators/passengers of my golf cart understand the rules and regulations governing its operations. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

I acknowledge that any violations committed by an operator/passenger of my golf cart will be considered a violation against my golf cart privileges for the purposes of determining my ability to register/renew this registration and for consideration in the revocation of my privileges by the town. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{ binding displayValue, mode=oneTime }

Rules and Regulations

Golf carts ARE NOT PERMITTED to be operated on any portion of the bicycle path, sidewalks, Coast Guard Road or Hwy 58/Emerald Drive. Golf carts are permitted to cross directly over Coast Guard Road or Hwy 58/Emerald Drive so long as it is in a straight line and at a 90-degree angle. Golf Carts ARE NOT PERMITTED to cross at the intersection of Coast Guard Rd and NC58/Emerald Drive.
OPEN CONTAINERS OF ALCOHOL ARE NOT PERMITTED on a golf cart, to include passengers! Anyone operating a golf cart under the influence of alcohol or other drugs can be arrested for Driving While Impaired!
No one UNDER THE AGE OF 18 is allowed to operate a golf cart.
Anyone operating a golf cart must have a valid State Issued driver’s license in their possession while operating a golf cart and must comply with all conditions and restrictions on their license.
A golf cart must display a valid town issued registration plate and current year decal on the REAR of the golf cart and an Emerald Isle Rules and Regulations sticker on the windshield during operation.
A golf cart may only transport as many people as there are seat belts. The seating capacity of seat belts may not be exceeded.
Each operator/passenger is required to be properly seated and have their own individual seat belt securely fastened while the golf cart is in motion. Children who are required by law to be in a car seat in a motor vehicle are also required to be in a car seat on a golf cart.
Golf carts may not be operated at a speed that is greater than reasonable and prudent under existing conditions and in no circumstances at a speed greater than 20mph.
Golf carts may not be operated in a careless or reckless manner.
Golf carts are required to be operated in accordance with all state motor vehicle laws, local traffic laws and local ordinances.
Golf carts are subject to the same parking restrictions, rules and regulations governing traditional motor vehicles and may only be parked in the same manner and same places designated for the parking of traditional motor vehicles. Golf carts are permitted to park in specially designated “golf cart only” parking spaces as may be provided by the Town in various locations.
Golf carts may only park in designated handicapped parking spaces if the operator/driver or passenger has a handicapped placard or sticker and it is clearly posted or displayed in the golf cart.
Golf carts may not be used to tow another cart, trailer or vehicle of any kind including a person on roller skates, bicycles, skateboards or other device.
Golf carts are required to yield the right of way to traditional motor vehicles.

Penalties

Each operator/passenger found to be in violation of a rule or regulation shall be subject to a civil citation and a fine of $50.00 per violation.
Any operator/passenger in violation of the North Carolina Motor Vehicle Code shall be subject to the penalties and fines prescribed in North Carolina law for said violation.
Operation of a golf cart while under the influence of an impairing substance on a public street, road or PVA is a violation of North Carolina law and is punishable as provided therein.
The Town may refuse to register and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, it the registered golf cart and/or the owner of the golf cart is involved in three (3) or more violations of this article and/or violations of North Carolina law within a three (3) year period. Said revocation shall be effective for one (1) year.
The Town may refuse to register and/or and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, if the registered golf cart and/or the owner of the golf cart is charged with operating a golf cart under the influence of an impairing substance, aiding and abetting the operation of the golf cart under the influence of an impairing substance, or operating a golf cart in a careless and reckless manner. Said revocation and/or denial of a permit shall be effective for one (1) year, unless the charge is dismissed or the owner and/or operator is acquitted, in which event the permit shall either be immediately reinstated or the application for the permit shall be approved if the conditions of the ordinance have been met.

I certify, under risk of forfeiture of privilege, that I have received a copy of the rules and regulations outlined above and that I have read, understand and agree to strictly adhere to all rules and regulations set forth and pertaining to the operation of golf carts within the Town of Emerald Isle. {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Signature of Owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Golf Cart Registration/Renewal Application

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{binding Name} - {binding Description}	{binding displayValue}
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(If Renewal) Enter Plate # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Current Golf Card Safety Class Test Results {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

*Note: Discounts are ONLY valid for the year in which the class was taken and may ONLY be applied to golf carts registered to the holder of the card.

Name of Rental Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Business Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Tax ID# {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Emergency Contact Person (after hours) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Owner/Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Co-Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Home Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Cell Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Other Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Emerald Isle address where golf cart is kept: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Handicapped Placard # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Current DMV Registration for Handicap Placard (Required) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Golf Cart Serial # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Year: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Color: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Insurance Company: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Policy Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Insurance Company Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Agent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Proof of Insurance Policy {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

{binding displayValue}

In order to process your application, you must read and indicate that you agree to abide by each of the following as a condition of your registration:

{binding displayValue}

Rules and Regulations

Golf carts ARE NOT PERMITTED to be operated on any portion of the bicycle path, sidewalks, Coast Guard Road or Hwy 58/Emerald Drive. Golf carts are permitted to cross directly over Coast Guard Road or Hwy 58/Emerald Drive so long as it is in a straight line and at a 90-degree angle. Golf Carts ARE NOT PERMITTED to cross at the intersection of Coast Guard Rd and NC58/Emerald Drive.
OPEN CONTAINERS OF ALCOHOL ARE NOT PERMITTED on a golf cart, to include passengers! Anyone operating a golf cart under the influence of alcohol or other drugs can be arrested for Driving While Impaired!
No one UNDER THE AGE OF 18 is allowed to operate a golf cart.
Anyone operating a golf cart must have a valid State Issued driver’s license in their possession while operating a golf cart and must comply with all conditions and restrictions on their license.
A golf cart must display a valid town issued registration plate and current year decal on the REAR of the golf cart and an Emerald Isle Rules and Regulations sticker on the windshield during operation.
A golf cart may only transport as many people as there are seat belts. The seating capacity of seat belts may not be exceeded.
Each operator/passenger is required to be properly seated and have their own individual seat belt securely fastened while the golf cart is in motion. Children who are required by law to be in a car seat in a motor vehicle are also required to be in a car seat on a golf cart.
Golf carts may not be operated at a speed that is greater than reasonable and prudent under existing conditions and in no circumstances at a speed greater than 20mph.
Golf carts may not be operated in a careless or reckless manner.
Golf carts are required to be operated in accordance with all state motor vehicle laws, local traffic laws and local ordinances.
Golf carts are subject to the same parking restrictions, rules and regulations governing traditional motor vehicles and may only be parked in the same manner and same places designated for the parking of traditional motor vehicles. Golf carts are permitted to park in specially designated “golf cart only” parking spaces as may be provided by the Town in various locations.
Golf carts may only park in designated handicapped parking spaces if the operator/driver or passenger has a handicapped placard or sticker and it is clearly posted or displayed in the golf cart.
Golf carts may not be used to tow another cart, trailer or vehicle of any kind including a person on roller skates, bicycles, skateboards or other device.
Golf carts are required to yield the right of way to traditional motor vehicles.

Penalties

Each operator/passenger found to be in violation of a rule or regulation shall be subject to a civil citation and a fine of $50.00 per violation.
Any operator/passenger in violation of the North Carolina Motor Vehicle Code shall be subject to the penalties and fines prescribed in North Carolina law for said violation.
Operation of a golf cart while under the influence of an impairing substance on a public street, road or PVA is a violation of North Carolina law and is punishable as provided therein.
The Town may refuse to register and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, it the registered golf cart and/or the owner of the golf cart is involved in three (3) or more violations of this article and/or violations of North Carolina law within a three (3) year period. Said revocation shall be effective for one (1) year.
The Town may refuse to register and/or and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, if the registered golf cart and/or the owner of the golf cart is charged with operating a golf cart under the influence of an impairing substance, aiding and abetting the operation of the golf cart under the influence of an impairing substance, or operating a golf cart in a careless and reckless manner. Said revocation and/or denial of a permit shall be effective for one (1) year, unless the charge is dismissed or the owner and/or operator is acquitted, in which event the permit shall either be immediately reinstated or the application for the permit shall be approved if the conditions of the ordinance have been met.

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Signature of Owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Golf Cart Registration/Renewal Application

{{ Cognito.resources['order-number-label'] }}: {binding displayValue}

{{ Cognito.resources['order-date-label'] }}: {binding displayValue}

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{{ Cognito.resources['order-amount-paid'] }}:	({binding displayValue})
{{ Cognito.resources['order-balance-due-label'] }}:	{binding displayValue}

(If Renewal) Enter Plate # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Current Golf Card Safety Class Test Results {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

*Note: Discounts are ONLY valid for the year in which the class was taken and may ONLY be applied to golf carts registered to the holder of the card.

Name of Rental Company {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Business Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Tax ID# {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Emergency Contact Person (after hours) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Phone {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Owner/Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Co-Applicant Name: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Drivers License # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Issuing State: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Home Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Cell Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Other Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Mailing Address {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Emerald Isle address where golf cart is kept: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Email {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Handicapped Placard # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Current DMV Registration for Handicap Placard (Required) {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

Golf Cart Serial # {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Make: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Year: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Color: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Insurance Company: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Policy Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Insurance Company Phone Number: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Agent: {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding displayValue}

Upload Proof of Insurance Policy {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

{binding Name, mode=oneTime}

{binding Description}

{binding displayValue}

In order to process your application, you must read and indicate that you agree to abide by each of the following as a condition of your registration:

{binding displayValue}

Rules and Regulations

Golf carts ARE NOT PERMITTED to be operated on any portion of the bicycle path, sidewalks, Coast Guard Road or Hwy 58/Emerald Drive. Golf carts are permitted to cross directly over Coast Guard Road or Hwy 58/Emerald Drive so long as it is in a straight line and at a 90-degree angle. Golf Carts ARE NOT PERMITTED to cross at the intersection of Coast Guard Rd and NC58/Emerald Drive.
OPEN CONTAINERS OF ALCOHOL ARE NOT PERMITTED on a golf cart, to include passengers! Anyone operating a golf cart under the influence of alcohol or other drugs can be arrested for Driving While Impaired!
No one UNDER THE AGE OF 18 is allowed to operate a golf cart.
Anyone operating a golf cart must have a valid State Issued driver’s license in their possession while operating a golf cart and must comply with all conditions and restrictions on their license.
A golf cart must display a valid town issued registration plate and current year decal on the REAR of the golf cart and an Emerald Isle Rules and Regulations sticker on the windshield during operation.
A golf cart may only transport as many people as there are seat belts. The seating capacity of seat belts may not be exceeded.
Each operator/passenger is required to be properly seated and have their own individual seat belt securely fastened while the golf cart is in motion. Children who are required by law to be in a car seat in a motor vehicle are also required to be in a car seat on a golf cart.
Golf carts may not be operated at a speed that is greater than reasonable and prudent under existing conditions and in no circumstances at a speed greater than 20mph.
Golf carts may not be operated in a careless or reckless manner.
Golf carts are required to be operated in accordance with all state motor vehicle laws, local traffic laws and local ordinances.
Golf carts are subject to the same parking restrictions, rules and regulations governing traditional motor vehicles and may only be parked in the same manner and same places designated for the parking of traditional motor vehicles. Golf carts are permitted to park in specially designated “golf cart only” parking spaces as may be provided by the Town in various locations.
Golf carts may only park in designated handicapped parking spaces if the operator/driver or passenger has a handicapped placard or sticker and it is clearly posted or displayed in the golf cart.
Golf carts may not be used to tow another cart, trailer or vehicle of any kind including a person on roller skates, bicycles, skateboards or other device.
Golf carts are required to yield the right of way to traditional motor vehicles.

Penalties

Each operator/passenger found to be in violation of a rule or regulation shall be subject to a civil citation and a fine of $50.00 per violation.
Any operator/passenger in violation of the North Carolina Motor Vehicle Code shall be subject to the penalties and fines prescribed in North Carolina law for said violation.
Operation of a golf cart while under the influence of an impairing substance on a public street, road or PVA is a violation of North Carolina law and is punishable as provided therein.
The Town may refuse to register and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, it the registered golf cart and/or the owner of the golf cart is involved in three (3) or more violations of this article and/or violations of North Carolina law within a three (3) year period. Said revocation shall be effective for one (1) year.
The Town may refuse to register and/or and issue a permit for the operation of a golf cart, or may immediately revoke a previously issued permit, if the registered golf cart and/or the owner of the golf cart is charged with operating a golf cart under the influence of an impairing substance, aiding and abetting the operation of the golf cart under the influence of an impairing substance, or operating a golf cart in a careless and reckless manner. Said revocation and/or denial of a permit shall be effective for one (1) year, unless the charge is dismissed or the owner and/or operator is acquitted, in which event the permit shall either be immediately reinstated or the application for the permit shall be approved if the conditions of the ordinance have been met.

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Signature of Owner {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

Date {{ Cognito.resources["required-asterisk"] }} , { binding firstError.message }

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Golf Cart Registration/Renewal Application

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Golf Cart Registration/Renewal Application

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Golf Cart Registration/Renewal Application

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