Badge Request

Badge Request

Please note that you will be required to upload a photo to complete this request. If you are a requesting a replacement badge, you will be required to make a $5.00 payment to complete this form. We will reach out if we require additional information or a different photo. Your badge will be in your mailbox within 72 hours of your request.
Name*

First NameLast Name
Are you a Homeowner or Renter?*
Check in date*

MonthDayYear
Date
Check out date*

MonthDayYear
Date
Do you need a new badge or replacement badge?*
Park Address?*
Phone Number*
Please enter a valid phone number.
Would you like your home state on your badge? *
Enter home state here *
Email*
example@example.com
Would like the fastener to be a clip or magnet (chose one)*
Would you like your badge in your mailbox or will you be picking it up?
Please upload your badge photo here. (Clear head shot only)*

Cancelof

Signature*

Clear
Date

MonthDayYear
Date
You consent and agree that your use of a keypad, mouse, or other device to select an item, button, icon, or similar act/action while using any electronic service we offer; constitutes your signature, acceptance, and agreement as if signed by you in writing. Further, you agree that no certification authority or other third-party verification is necessary to validate your electronic signature; and that the lack of such certification or third-party verification will not in any way affect the enforceability of your signature or resulting contract between you and Roadhaven. You understand and agree that your eSignature executed in conjunction with the electronic submission of this form will be legally binding and such transaction will be considered authorized by you and constitutes your agreement to be bound by the terms and conditions of the electronic service as they exist on the date of your eSignature on this form.
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