REGISTRATION & AUTHORIZATION FORM

RiverView RV Resort Owners' Association, Inc.

2000 E. Ramar Rd. Bullhead City, AZ 86442

Riverview RV Resort is qualified as an age 55 or older development under the Fair Housing Amends Act of 1988. One resident in each household SHALL have passed their 55th birthday at the time of occupancy. ALL residents of the Resort SHALL have passed their 35th birthday. You SHALL be asked to show proof of age. All residents must abide by the Rules & Regulations as stated in the Resort documents.

Lot No______________

Owners Name_________________________ Representative Name________________________________

As Owner or Owner's Representative of the above mentioned Lot, this agreement authorizes the following person(s) to occupy said Lot from_____________________________to__________________________________.

(start date)

(end date)

__________________________________________________________ Phone______________________

(Owners Signature or Owners Representative)

(date)

(contact phone number)

Required Processing Fee $30.00 ____________________________How Paid _____________________

Late Fee $20.00__________________How Paid_________________

(Less than 72 hours notice)

Renter's Information

Attach copy of Drivers License

Name______________________________________________Birth Date (Required)____________________

Name______________________________________________Birth Date(Required)____________________

Home Address_________________________________________________________________________________

Home Phone_______________________________Local Contact Phone____________________________

EMERGENCY CONTACT INFORMATION:

Name__________________________________________________Relationship_____________________________

Address_______________________________________________________________________________________

Contact Phone Number:______________________________________________________

----------------------------------------------------------------------------------------------------------------------------------------------------------

Type of Property: Circle One RV Type if Lot Only: Circle One

Park ModelMotor Home

Vacant LotFifth Wheel

Trailer

RV Make_________________Length___________Year__________License #________________________

Backflow preventer is required on all RV types per the County Health Department

(may be purchased at the office)

Passenger Vehicle Registration:

Vehicle 1

______________/_______________/________________/______________/_________/___________________

Make Model License # Color Year Proof of Registration

Vehicle 2

______________/_______________/_________________/______________/_________/___________________

Make Model License # Color Year Proof of Registration

Please bring your vehicle registration. It is needed to issue the vehicle pass by the office. No RVs OVER 10 YEARS OLD without Inspection. No RVs OVER 15 Years allowed into Resort unless it is a returning RV and passes Inspection

Pet Information

Please refer to governing docs concerning pets

We have a pet. Circle One.

Cat __________________Ibs Dog ___________________lbs Other ___________________lbs

Description of Pet__________________________________________Rabies Tag #_______________________

I do not have any pets. ____________(Initials)

I/We have received and read: Copy of Rules & Regulations___________Copy of Gate Policy_________

Renter Signature_____________________________________________________________Date_______________