Endless Season Riders Snowmobile / ATV Club - Plymouth, Maine
Endless Season Riders Snowmobile / ATV Club - Plymouth, Maine
2008/2009 Endless Season Riders Family Membership Form
***Name:
***Address:
***Town:
***State:
***Home #:
***Cell #:
***Email:
Any Additional Info?
***ZIP Code:
***Spouse:
***Date of Birth (required for MSA):
***Spouses Date of Birth:
Email (if you have another):
Text Notifications:
*** denotes a required field if no info is available enter N/A or NONE ***
How many ATV's do you own?
How many Snowmobiless do you own?
Are you an ATV Rider?
Are you a Snowmobile Rider?
ATV MAINE & ATV CLUB MEMBERSHIP BENEFITS:
Include a one year subscription to the ATV MAINE publication, ATV MAINE decal, access to www.atvmaine.org which publishes maps and trail conditions, representation at the state level on legislative issues pertaining to ATV riding including trail funding, landowner relations, and fellowship with other ATV MAINE family members and businesses.
MSA & SNOWMOBILE CLUB MEMBERSHIP BENEFITS:
Include primary member $2000 accidental death & dismemberment insurance through the Maine Snowmobile Association, an MSA decal, one year subscription to The Maine Snowmobiler, access to www.mesnow.com which publishes maps and trail conditions, representation at the state level on legislative issues pertaining to snowmobiling including trail funding, landowner relations, and fellowship with other MSA family members and businesses. Additional insurance is available for spouses and dependants ages 19 and under for an additional cost of $2 each. (Please list additional members below).
Dependent Name:
D.O.B:
Relationship:
Dependent Name:
Dependent Name:
Dependent Name:
D.O.B:
D.O.B:
D.O.B:
Relationship:
Relationship:
Relationship:
Dependent Name:
D.O.B:
Relationship:
***Beneficiary Name:
D.O.B:
Relationship:
Endless Season Riders 2008/2009 Club Dues
ATV Maine Dues ($10.00)
(Club Name)
Maine Snowmobile Association Dues ($12.00)
(Club Name)
MSA Dependent coverage (from above) $2.00 each
Total Amout Due:
Thank You for submitting online. You will need to mail your dues to:
Endless Season Riders
PO Box 56
Plymouth, Maine 04969
Your membership will be complete once your dues are received.
