IN ORDER TO RECEIVE PARKING PASSES, PLEASE READ THE FOLLOWING, COMPLETE THE REVERSE SIDE IN ITS ENTIRETY, SIGN AND DATE IT.



By signing the bottom of this application, I hereby acknowledge that I have completely read and understand the above rules and regulations. I further acknowledge that I understand the above rules and regulations to be only a summary of the actual parking rules and regulations, and that I have received, along with this document, the full and complete list of parking rules and regulations, and that I have completely read and understand the parking rules and regulations. I understand that I must sign and date this document in order to receive any and all parking passes that I may be entitled to and that by signing this document, I take full responsibility for informing all residents and guests associated with my unit of the parking rules and regulations.

HEATHERLEA
PARKING & RECREATION PASS APPLICATION

- PLEASE PRINT CLEARLY

Unit Address:Home Phone Owner: Renter:
I. Adult Residents
(If renters, must be on lease)
Work PhoneEmail (Optional)Office Use
1.
2.
3.
II.Resident ChildrenDate of BirthOffice UseIII. Pets (Cats and Dogs Only)
1. Name:Breed:
2. Cat:Dog:
3. Cat:Dog:

Guest Recreation Passes: Office use only ___________ ___________
IV. Vehicles (Maximum of two passes per unit.) Residents must submit a copy of current vehicle registration(s) with Heatherlea address or current vehicle registration(s) and other identification showing resident's name and address. This information must be submitted each year, for each vehicle.
Make/Model Owner Tag # Office Use
RESERVED
SECONDARY
Guest parking, a maximum of 2 per unit. Office use only ___________ ___________
NOTE: Replacement of lost or stolen resident & guest parking passes is $10.00 each. (Check or money order only, cash is not accepted.)
V. Emergency Contact Information: All residents must list at least one emergency contact.
Name Relationship Phone Contact
H. W.
H. W.

VI. Landlord Information: If you are a renter, you must provide the name, address, and phone numbers for your landlord.
Name Address City, State, Zipcode
Phone Numbers W. C. H.

VII. Certification:I am an owner or listed lessee of the unit identified above (you must have a settlement sheet or current lease on file.) I certify that the information listed above is accurate and the residents listed above are full-time residents of the unit. I and each of the residents recognize that the use of the recreational facilities and parking is subject to the rules and regulations for our use and that violation of these rules may lead to termination of our right to use the facilities.
Signature: ____________________________________ Date: __________________________