Please complete the following form to register your Golf Cart or Slow Moving Vehicle. Please see Ordinance 375-2014, which governs the operation of Golf Carts and Slow Moving Vehicles in Youngsville.Owner/Registrant Name:(Required)Vehicle Model/Year:(Required)VIN/Serial #(Required)Insurance Company Name(Required)Insurance Expiration Date(Required) Month Day YearInsurance Policy #(Required)Driver's License #(Required)Owner/Registrant Email(Required) Owner/Registrant Phone(Required)Owner/Registrant Address:(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Owner/Registrant Subdivision:(Required)License Plate Number:Registration Expiration Date(Required)Required EquipmentRequired Equipment(Required)Please check the box to acknowledge your vehicle has each type of required equipment. Headlights Front & Rear Turn Signals Tail Lights Brake Lights Reflex Reflectors Exterior Driver's Side Mirror Passenger Side Mirror OR Rear View Mirror Parking Brake Windshield Type I or Type II Seatbelts at each designated seatAcknowledgements & Digital SignatureIndemnification(Required) I hereby freely obligate myself as the undersigned owner and registrant to indemnify, defend, and hold the City of Youngsville, its officers, agents, servants, employees, assistants, legal representatives and their heirs, executives, executors, administrators, and assigns completely harmless from and against any and all liabilities, losses, suits, claims, judgments, fines, or demands arising by reason of injury or death of any person or damage to any property, including all reasonable costs of investigation and defense thereof, included but not limited to, attorney fees, court costs, and expert fees, of any nature whatsoever arising out of an incident to the acts or omissions of the Owner and Registrant, its officers, agents, employees, contractor, subcontractors, subleases, licensees, invitees, or any third party persons in use of the Owner's and Registrant's Gold Cart or Slow Moving Vehicle, regardless of where the injury, death, or damage may occur.Acknowledgement of Receipt of Ordinance 375-2014(Required) Furthermore, by attaching my signature below, I hereby acknowledge and witness that I have received a copy of City of Youngsville Ordinance No. 375-2014 and that I will abide by the requirements within Ordinance No. 3575-2014.Ordinance 375-2014Upload of Documents Required(Required)I will upload a copy of my driver's license, proof of insurance information, and VIN # to the link provided in the confirmation email after submitting this form. Please select the documents you will be uploading below Your driver's license Proof of Insurance (including insurance company name, policy # and expiration date) Vehicle VIN # (this might be included on your proof of insurance)Digital Signature(Required)Please type your name below, which serves as your digital signature.CAPTCHANumberUntitledPhoneThis field is for validation purposes and should be left unchanged.