Salishan Leaseholders, Inc.
P.O. Box 219
Gleneden Beach, OR 97388
___________________________________________
Leaseholder
___________________________________________
Sub-registered to
______________
Card No.
This card is exclusively for your own individual use and shall not be loaned or transferred to any other person.
The Speed Limit ( 18 MPH ) and all other rules of the roadways shall be strictly observed.
This card is the property of Salishan Leaseholders, Inc. and it is hereby understood that any violation of the above restrictions may result in the card being voided from the system.
Receipt of the card is acknowledged. I have read and understand the foregoing rules and agree to them.
____________________, 20______ _______________________________
Signature
Drivers Lic. #___________________
Card Authorized by _________________________________________
Leaseholder’s Signature
Salishan Address__________________________
