Required fields are marked with asterisks (*)

Tenant Vehicle Parking Registration Form

Section A – Tenant & Vehicle Information

Please note: Parking spaces are limited and completing this form does not guarantee a space. A waitlist is maintained by staff, and spaces are assigned based on availability.

First name

Last name

Street number

Street name

Unit number

City

Postal code

Phone number

Email address

Re-enter email address

Vehicle 1

Vehicle Plate No:

Vehicle Make:

Vehicle Model:

Vehicle Colour:

Vehicle 2

Vehicle Plate No:

Vehicle Make:

Vehicle Model:

Vehicle Colour:

Vehicle 3

Vehicle Plate No:

Vehicle Make:

Vehicle Model:

Vehicle Colour:

Are you replacing a vehicle that was previously registered with COB Housing?

YES, this is a replacement vehicle

NO, this is an additional vehicle I am registering

Is an Accessible Parking Spot Required?

YES

Section C – Terms and Conditions

I agree:

to inform the City of Brantford Housing should I/we no longer own the vehicle recorded on this registration form, or no longer require a parking space for the Housing site.

I agree:

That I/we confirm that I/we reside at the listed address, understand that maintenance work is not permitted in the parking lot, the vehicle is legally operable, and inoperable vehicle (ie flat tires) may be towed at my/our expense.

Personal Information

I consent to

City of Brantford Housing’s verification of the information on this form. I understand the information will be used to determine my continued eligibility for a parking permit according to City of Brantford Housing Parking Policy and Procedures.

Waiver – Damage to Automobiles/Damage or Loss of Contents

The Tenant agrees

that the Landlord, City of Brantford Housing and its directors, officers, employees and agents including their successors and assigns (collectively, the ”Landlord”), shall not be liable to the Tenant for loss or damage to the authorized vehicles(s) or its/their contents, nor, without limiting the foregoing, for any such loss or damage to the authorized vehicle(s) or its/their contents that may in any part be attributable to the negligence of the Landlord, however or by whomsoever caused, while the said authorized vehicle(s) is/are parked, entering or exiting the property for which the permission to park is granted.

Applicant Consent

By checking this box,

I acknowledge having read and understood Section C TERMS & CONDITIONS for Tenant Parking on City of Brantford Housing Property. I authorize and consent to the completion of this form and its submission to the City of Brantford Housing and Homelessness Services Department and to the disclosure to the City of Brantford of any additional information it may request to clarify the information on this form.

Privacy Notification and Consent

Personal Information

contained in this form or in any attachments is collected by the City of Brantford Housing & Homelessness Services Department in accordance with the Freedom of Information and Protection of Privacy Act or the Municipal Freedom of Information and Protection of Privacy Act, and will be used to determine continued eligibility for a parking permit according to City of Brantford Housing and Homelessness Services Parking Policy and Procedures.

Form Builder

Tenant Vehicle Parking Registration Form

Section A – Tenant & Vehicle Information

Vehicle 1

Vehicle 2

Vehicle 3

Section C – Terms and Conditions

Personal Information

Waiver – Damage to Automobiles/Damage or Loss of Contents

Applicant Consent

Privacy Notification and Consent