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Mobility Impaired Spectator Cart Request Form

Date of Event
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DO YOU HAVE A VALID, STATE-ISSUED DISABILITY PARKING PLACARD/CARD OR OTHER STATE ISUED PROOF OF DISABILITY:

Please sign below stating the following: "I hereby certify that I am requesting use of a club-provided cart because I have a mobility disability that makes it necessary". All requests are pending until approved by the MASS GOLF and the host club -- based on their ability to accommodate said request. By submitting this request, you are agreeing to release the MASS GOLF, the host club and any related parties from any liability for injuries or other liabilities from your operation of the cart and to indemnify and hold them harmless from any claims by third parties arising out of your use of the cart.*:

Please Print Name Below 

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