Standish Gorham

Standish Gorham

ATV Club

Standish Gorham ATV Club, Inc.

2007 - Membership Applicatio= n Form

____$30.00 – Supporting Business Member (contact the club for more info)

&nbs= p; ____$20.00 – Primary membership (includes Spouse + children under 18) &nb= sp;

____ $15.00 – Associate membership (before joining as an Associate member, a

current year Pri= mary membership with another A.T.V. Maine affiliated club is required)

Membership is due in April o= f each year.

New___ Renewal___

Please print clearly.<= /p>

Pri= mary Club: ______________________________________________________

Ass= ociate Club(s): __________________________________________________

Nam= e: ____________________________________________DOB:____/____/____

&nbs= p; &= nbsp; Address: ______________________________________

MSA member: yes___ no___ &n= bsp; SAM member: yes___ no___ &= nbsp; &nbs= p;

Tow= n/ State/ Zip: ___________________________________________________

Pho= ne: ___________________ E-mail: __________________________________

Spo= use: __________________ Children: ________________________________

ATV/ Year/ Make/ Reg #: __________________________= ___________________

&nbs= p; &= nbsp; Areas of Interest: ___Trail work + any equipment ________________________= __

__L= andowner relations __Safety training __Search+Rescue __Boards/Committees

__F= undraising = ; __Officers __Activities/Events __Help where needed

&nbs= p; &= nbsp; How/where did you here about the SG ATV Club? ________________________ = ; &nb= sp;

&nbs= p; &= nbsp; I understand that by signing this form, my membership can be discontinued= at any time if

= &nb= sp; the club or its officers have reason to believe that I or a member of my family operates an ATV

= &nb= sp; irresponsibly so that it endangers the landowner/club relationship or if = it is believed

= &nb= sp; that the operator could cause harm to another individual. My membership fee is non-refundable

&nbs= p; &= nbsp; and it is intended to be used to support the club whole. I also agree to hold harmless the SG

= ATV Club from all liabilities resulting from my involvement with the club= .

Signature: ________________________________________ Date: ____/____/____

Meetings held 3rd Thursday of each month at the West Gorham Fire Barn on Rt. 25

Ple= ase come to our next meeting or mail this form to:

= &nb= sp; = &nb= sp; = &nb= sp; Standish/ Gorham ATV Club

P.O. Box 664

Gorham, ME 04038

&= nbsp; &nbs= p; &= nbsp; &nbs= p; Please make che= cks payable to: Standish Gorham ATV Club

Tread Lightly and Ride Safe =

On Public and Private Lands