Narraguagus ATV Club, Inc.         

e-mail: narraguagusatv@earthlink.net

www. http://home.earthlink.net/~narraguagusatv/

2009 - Membership Application Form

____$50.00 –  Supporting Business/Family Member (contact the club for info)

____$40.00 – Supporting Business Member (contact the club for more info)

            ____$25.00 – Primary membership (includes Spouse + children under 18)        

           ____ $20.00 – Associate membership (before joining as an Associate member, a

           current year Primary membership with another A.T.V. Maine affiliated club is required)

Membership is due in April of each year.

Membership also includes: membership to ATV Maine, a $2000 accidental death insurance for each member, and the ATV Maine Newspaper which is published minimum 4 times per year

     New___ Renewal___

Please print clearly.

Name: ____________________________________________DOB:____/____/____

Address: ______________________________________

Town/ State/ Zip: ___________________________________________________

Phone: ___________________ E-mail: __________________________________

Spouse: __________________ Children: ________________________________

ATV/ Year/ Make/ Reg #: _____________________________________________

_________________________________________________________________

MSA member: yes___ no___                SAM member: yes___ no___ 

Member of another ATV Club   yes___    No ____  Name of club  ______________                  

Areas of Interest: ___Trail work + any equipment __________________________

__Landowner relations __Safety training __Search+Rescue __Boards/Committees

__Fundraising              __Officers           __Activities/Events  __Help where needed

How/where did you here about the Narraguagus ATV Club? ________________________                   

I understand that by signing this form, my membership can be discontinued at any time if the club or its officers have reason to believe that I or a member of my family operates an ATV irresponsibly so that it endangers the landowner/club relationship or if it is believed

that the operator could cause harm to another individual. My membership fee is non-refundable and it is intended to be used to support the club as a whole.

I also agree to hold harmless the Narraguagus ATV Club from all liabilities resulting from my involvement with the club.

Signature: ________________________________________ Date: ____/____/____

Second Wednesday of the month at Narraguagus Snowmobile Clubhouse 334 Ridge Road Cherryfield

Please come to our next meeting or mail this form to:

Narraguagus ATV Club  PO Box 453  Cherryfield, ME  04622                                         

Please make checks payable to: Narraguagus ATV Club

Tread Lightly and Ride Safe

On Public and Private Lands