BUMC Parking Permit Application | Transportation Services

Name*

First Last

ID Number*

Email*

Enter Email Confirm Email

Student?*

Department*

Building & Floor*

Phone*

Vehicle Information

Vehicle 1: Make*

Vehicle 1: Model*

Vehicle 1: Color*

Vehicle 1: License Plate Number*

Vehicle 1: License Plate State

Second Vehicle Information (optional)

Vehicle 2: Make

Vehicle 2: Model

Vehicle 2: Color

Vehicle 2: License Plate Number

Vehicle 2: License Plate State

Payment Method

Paycheck Issued by:*

Payment Type:*

Payroll Deduction*
Credit Card/ Check*

Permit Preferences

Parking Facility Choice # 1*

Parking Facility Choice # 2*

Permitholder Agreement

All Applicants must read and agree/disagree below:*

Agree

I agree to comply with BUMC parking rules and regulations and I understand if my vehicle is parked in violation of any such rules and regulations, it may be towed at my expense. I further understand that violation of BUMC rules, regulations, or policies may lead to suspension or termination of my parking privileges. By agreeing to these policies and procedures, I understand that it is my obligation to cancel parking at the conclusion of need of parking, and that the Parking Office is not responsible for any refunds due to failure to cancel. I assume all risk of injury to person and/or loss of or damage to property of every kind while in a BUMC parking lot, and I expressly release and hold harmless BUMC and their respective agents and employees from any and all liability for injury to person and/or loss or damage to property of every kind, including without limitation, any automobile and it's contents. *This amount is based on parking rates in effect as of the date of this application. Rates are subject to change. Accordingly, no less than 30 days after publication of any rate change, payroll deduction amounts may be adjusted and/or additional pre-payment may be required.