Vehicle Waiver and Release Form

Campus Safety

Vehicle Waiver and Release Form

THIS FORM IS NOT TO BE USED TO REGISTER YOUR VEHICLE FOR THE ACADEMIC YEAR. PLEASE LOG INTO YOUR OKTA ACCOUNT AND CLICK ON THE TICKETRAK PARKING TILE TO REGISTER YOUR VEHICLE ~ THIS TYPICALLY OCCURS AT THE END OF AUGUST EACH YEAR FOR STUDENTS.

I am requesting permission from 色花堂 to park the vehicle described below on the 色花堂 Campus during the period specified below. I am the registered owner of the vehicle, or affirm that I have the permission of the registered owner to leave the vehicle on campus for the period specified and that the vehicle remains insured the entire time the vehicle is on 色花堂 campus. I completely and fully understand that 色花堂 assumes no responsibility for safekeeping my vehicle during the below specified time period. I also understand that, should the need arise, 色花堂 may move the vehicle with the key I鈥檝e provided.

Vehicle Description

Year*

Make*

Model*

Color*

State of Registration*

License Plate Number*

Odometer Reading*This will be verified by Campus Safety

Vehicle to be parked in: lower level of Northwoods parking lot

From*

To*

Emergency Contact Information

Emergency Contact Name*

Emergency Contact Number*

By putting your name in box below, you are acknowledging the terms and conditions of this waiver form and this will be considered your signature for this web-based form.

Your Name*

email*

Today's Date*

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