Membership Form

Become a member of the Adirondack ATV Riders Club, Inc. Memberships may be done by mail or at the monthly meetings.

Membership:

$50.00 per family

$30.00 for renewal

$30.00 single

$20.00 renewal

Military Rate:

$40.00 per family

$25.00 for renewal

$25.00 Single

$15.00 Renewal

Name(s):	_______________________________________________________
	_______________________________________________________
Address:	_______________________________________________________
	_______________________________________________________
Phone:	_______________________________________________________
Date: E-Mail:	_______________________________________________________ _______________________________________________________

_____ New Member_____ Renewing Member
_____ Single Membership _____ Family Membership*
# of ATV’s owned _______

Please send check or money order to:
Adirondack ATV Riders Club, Inc.
PO Box 342
Harrisville, NY 13648

In consideration of this waiver being accepted, and desiring to be legally bound to myself, my heirs, executors and administrators, I hereby waive any of the sponsoring groups, officials, owners, operators of facilities, any and all private landowners, homeowners, attendants, and/or any and all people connected with the Adirondack ATV Rider’s Club, Inc.; club’s officers, Board of Directors or any of the club facilities, any liabilities for any and all injuries suffered by my self, my child and/or (children) at any event or activity to which this organization is related. I further certify that my child and/or (children’s) ATV is registered and insured when participating in any club event and I am the Parent and/or Legal Guardian. If the ATV is not registered, I agree to compete/ride in hosted events on the premises only. Any one who is under the age of 18 must be accompanied by and have a signature by a Parent and/or Legal Guardian.

Member(s) Signature:


Parent/Legal Guardian Signature:

Minors Name:	1)
	2)
	3)