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NAME______________________________________________________RENEWAL / NEW

ADDRESS____________________________________________________________________

CITY/TOWN__________________________________________ STATE_____ ZIP__________

EMAIL______________________________________________________________________

NUMBER OF FAMILY MEMBERS_______ TELEPHONE_____________________________

NAMES OF FAMILY MEMBERS_________________________________________________

INDIVIDUAL / FAMILY $20.00__________BUSINESS $35.00______________>

CENTRAL MAINE ATV CLUB PO Box 303 FAIRFIELD, ME 04937

***membership fee is due by July 1, 2011***

DATE PAID_______________________ CASH / CHECK

 

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Please mark any of the following that you would be interested in doing

_____ Work on trails

_____ Bridge Work

_____ Trash Removal on trails

_____ Fund Raising

_____ Operate Equipment

_____ Run for Office

*****For new members, please write in the name of the person who referred you to our club.