Golf Cart Permit Renewal Application

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TEUTOPOLIS

Golf Carts & Recreational
Off-Highway Vehicles (Side-by-Sides)

Golf Cart Permit Renewal Application

This application is for a permit sticker to operate a “golf cart” on the Village of Teutopolis streets in accordance with the Village of Teutopolis “Code of Ordinance” book for the year beginning January 1, 2026, through December 31, 2026. I certify that by signing this permit, the golf cart is the same as inspected and all required equipment is in working order. I agree to follow all rules in operating the cart on village streets, and if stopped for any reason, the officer may choose to do a complete inspection and if the driver is in violation of the ordinance, a fine will be imposed. Stickers must be placed on the lower half of the windshield on the passenger side and the rear fender on the passenger side, like in previous years.

Once you have submitted the form, please use the link below to make your payment.

This permit renewal expires on 12-31-26.

Pay Online

Applicant Information

Name *

Date of Birth *

Month *

Day *

Year *

Address *

Phone Number *

Driver's License Number *

Expiration Date *

Month *

Day *

Year *

Golf Cart Information

Old Permit Number *

Model *

Color *

Cart VIN Number *

Number of Seat Belts *

Liability Insurance Carrier *

Policy Number *

Attach Liability Insurance Policy

No file chosen

By completing this form, you agree to abide by the terms of operating a Golf Cart or Recreational Off-Highway Vehicle (Side-by-Side) in the Village of Teutopolis. *

UNCONDITIONAL AND FULL GENERAL RELEASE OF LIABILITY, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE

THIS IS A LEGALLY-BINDING UNCONDITIONAL AND FULL GENERAL RELEASE OF LIABILITY, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE MADE BY ME, THE INDIVIDUAL COMPLETING THE FORM, (HEREINAFTER REFERRED TO AS OPERATOR) TO THE VILLAGE OF TEUTOPOLIS, ILLINOIS, ITS VILLAGE BOARD, TRUSTEES, OFFICERS, AGENTS, AND EMPLOYEES (HEREINAFTER COLLECTIVELY REFERRED TO AS THE “VILLAGE”).

I FULLY RECOGNIZE THAT THERE ARE DANGERS AND RISKS TO WHICH I MAY BE EXPOSED BY OPERATING A NON-HIGHWAY VEHICLE ON VILLAGE STREETS AND ALLEYS. THE FOLLOWING IS A DESCRIPTION AND/OR EXAMPLES OF SIGNIFICANT DANGERS AND RISKS ASSOCIATED WITH THIS ACTIVITY: INJURY TO MYSELF OR OTHERS, DAMAGE TO MY PROPERTY OR THAT OF OTHERS, DEATH OF MYSELF OR OTHERS.

IN NO EVENT SHALL THE VILLAGE BE LIABLE FOR DIRECT, INDIRECT, SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, WHETHER ARISING IN TORT, CONTRACT OR ANY OTHER LEGAL THEORY, IN CONNECTION WITH OR ARISING OUT OF OPERATOR’S USE OF A NON-HIGHWAY VEHICLE ON VILLAGE STREETS OR ALLEYS.

THE OPERATOR, AS OF THE DATE BELOW, SHALL HEREINAFTER SAVE, HOLD HARMLESS AND INDEMNIFY THE VILLAGE AGAINST ANY AND ALL LIABILITY, CLAIMS, CAUSES OF ACTION, AND COSTS OF WHATSOEVER KIND AND NATURE INCLUDING, WITHOUT BEING LIMITED TO INJURY, DAMAGE, LOSS INCLUDING DEATH, RESULTING FROM, ARISING OUT OF, OR OCCURRING IN CONNECTION WITH THE USE OF THIS NON-HIGHWAY VEHICLE ON VILLAGE STREETS OR ALLEYS.

I UNDERSTAND THAT THE VILLAGE HAS AN ORDINANCE GOVERNING THE USE OF A NON-HIGHWAY VEHICLE ON VILLAGE STREETS AND ALLEYS AND HEREBY AGREE TO CONFORM WITH ALL REQUIREMENTS OF THE VILLAGE ORDINANCE AT ALL TIMES. I HAVE HAD THE OPPORTUNITY TO READ SAID ORDINANCE AND MY SIGNATURE BELOW ACKNOWLEDGES THAT I WILL COMPLY WITH THIS ORDINANCE AND ALL OF THE APPLICABLE TRAFFIC LAWS OF THE STATE OF ILLINOIS AT ALL TIMES WHEN OPERATING THIS NON-HIGHWAY VEHICLE ON VILLAGE STREETS AND ALLEYS.

I, THEREFORE, AGREE TO ASSUME AND TAKE ON MYSELF ALL OF THE RISKS AND RESPONSIBILITIES IN ANY WAY ASSOCIATED WITH THIS ACTIVITY. IN CONSIDERATION OF AND RETURN FOR THE OPPORTUNITY TO OPERATE A NON-HIGHWAY VEHICLE ON VILLAGE STREETS AND ALLEYS, I RELEASE THE VILLAGE (AND THE BOARD OF TRUSTEES, OFFICERS, EMPLOYEES, AND AGENTS) FROM ANY AND ALL LIABILITY, CLAIMS, AND ACTIONS THAT MAY ARISE FROM INJURY OR HARM TO ME OR OTHERS, INCLUDING DEATH, OR FROM DAMAGE TO MY PROPERTY OR PROPERTY OF ANY OTHER IN CONNECTION WITH THIS ACTIVITY. I UNDERSTAND THAT THIS RELEASE COVERS LIABILITY, CLAIMS AND ACTIONS CAUSED ENTIRELY OR IN PART BY ANY ACTS OR FAILURES TO ACT ON MY PART, INCLUDING BUT NOT LIMITED TO NEGLIGENCE, MISTAKE, OR FAILURE TO ENFORCE, SUPERVISE OR MAINTAIN.

I ASSURE THE VILLAGE THAT THERE ARE NO HEALTH-RELATED REASONS OR PROBLEMS WHICH PRECLUDE OR RESTRICT MY PARTICIPATION IN THIS ACTIVITY. I FURTHER ASSURE THE VILLAGE THAT I HAVE ADEQUATE HEALTH AND LIABILITY INSURANCE NECESSARY TO PROVIDE FOR AND PAY ANY MEDICAL COSTS OR PROPERTY DAMAGE THAT MY DIRECTLY OR INDIRECTLY RESULT FROM MY PARTICIPATION IN THIS ACTIVITY, AND I WILL INDEMNIFY AND HOLD THE VILLAGE HARMLESS FOR ANY SUCH MEDICAL COSTS OR PROPERTY DAMAGE.

I UNDERSTAND THAT THIS RELEASE MEANS I AM GIVING UP, AMONG OTHER THINGS, RIGHTS TO SUE THE VILLAGE, ITS VILLAGE BOARD OF TRUSTEES, TRUSTEES, OFFICERS, EMPLOYEES, AND/OR AGENTS FOR INJURIES (INCLUDING DEATH), DAMAGES, OR LOSSES I MAY INCUR OR CAUSE. I ALSO UNDERSTAND THAT THIS RELEASE BINDS MY HEIRS, EXECUTORS, ADMINISTRATORS, AND ASSIGNS, AS WELL AS MYSELF.

I HAVE READ THIS ENTIRE RELEASE, I FULLY UNDERSTAND IT, AND I AGREE TO BE LEGALLY BOUND BY IT.