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2. City of Whitewater

   312 W. Whitewater St
   PO Box 178
   Whitewater, WI 53190
   262-473-0500

3. Golf Cart Registration Form
5. Per City of Whitewater Municipal Code 11.39, no golf cart may be operated on any public street within the City of Whitewater unless the golf cart has first been registered with the City of Whitewater City Clerk. Complete the following form and submit. You will be contacted when your registration is complete.
7. Golf Cart Owner's Name:*
9. Golf Cart Owner's Street Address:*
11. City, State Zip Code*
13. Golf Cart Owner's Mailing Address (if different from above):*

    If the mailing address is the same as the street address indicate by entering the word Same.

15. Golf Cart Owner's Phone Number:*
17. Golf Cart Owner's Email Address:*

    If no email enter the word None.

19. Golf Cart Make:*
20. Golf Cart Model:*
22. Golf Cart ID or Serial Number:*
24. Proof of Insurance - Company Name:*
26. Last Four Digits of Policy Number:*
28. Insurance Card Upload
30. Acknowledgement of Understanding*

    1. I, the registrant, have read and understand the City of Whitewater Municipal Ordinance Chapter 11.39 Operation of Golf Carts on Public Roads.
32. Signature of Applicant *
33. Date*
Leave This Blank:


35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field