Golf Cart Safety Acknowledgment Form
Please complete this form to acknowledge your understanding and agreement to follow all golf cart safety rules and operating procedures.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Golf Cart Identification Number or Description
*
Authorized Area(s) for Golf Cart Operation
*
Please Select
Golf Course Only
Golf Course and Clubhouse Area
All Designated Facility Areas
Other (please specify below)
If 'Other,' please specify authorized area
I have read and understand all golf cart safety rules and agree to operate the cart responsibly.
*
I acknowledge and agree
I do not agree
I understand that any incidents or accidents involving the golf cart must be reported immediately.
*
I acknowledge and understand
Emergency Contact Name and Phone Number
*
Signature (please sign below to confirm your acknowledgment)
*
Submit Acknowledgment
Submit Acknowledgment
Should be Empty: