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Form
10-07
Central Mountains
All-Terrain Vehicle Association Inc
P. O. Box No. 4
Lock Haven, PA 17745
Application for Membership
(make checks payable to the above)
www.cmatva.org
NAME:
_______________________________________________________________
AGE: _______________
ADDRESS:
____________________________________________________________
CITY:
______________________________________________
STATE: _______ ZIP:
________________
PHONE: (________)
____________________ E-MAIL
ADDRESS:
_____________________________________
(Important)
*Membership Dues:
New or Renewal (See Criteria for Membership on back)
Single: $10/1year or Family: $15/1year
Please, Laminate my card for $1 extra
VERY IMPORTANT: If under 18, Parents or
Guardian must also sign this
Application!
_____________________
- Signature(s) -
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------
·
What do you
Ride? ATV Dirt
Bike Do you……Hunt
____? Fish ____?
·
Registered
Voter? Yes
No AMA
Member: Yes No
·
Is your ATV
Registered? Yes
No Do you have
Liability Insurance? Yes No
·
Do you wear a
Helmet? Yes No
·
Ride
Preference? Trail Group Rides
Poker Runs Alone Anything
If a Family Membership is selected,
please list Name and Date of Birth of all
those who will be included:
Name
Date of Birth
___________________________
_____________________
___________________________
_____________________
___________________________
_____________________
___________________________
_____________________
___________________________
_____________________
1
Read Carefully Before Signing
1
I, the
undersigned, hereby apply for membership in
the Central Mountains All-Terrain Vehicle
Association Inc. and agree to abide by
all association
rules and
bylaws. I agree that I will be legally
bound by this application under the Uniform
Written Obligations Act of the Commonwealth
of
Pennsylvania.
I further acknowledge that I am aware of the
risk of injury to myself and to my property
while participating in ATV activities. I
will rely
on my own
judgment and common sense while
participating. I will also assume full
responsibility for any injury or damage I
cause during that participation.
I hereby
release Central Mountains All-Terrain
Vehicle Association Inc. of and from any
liability for personal injuries or property
damage that have
occurred as a
result of this participation. I also agree
that I will not bring any legal action or
make any claim what so ever against
Central Mountains
All-Terrain
Vehicle Association Inc.
or any organizers or volunteers of
its events for any injuries or damage
incurred from or during these events.
When signing this application for a Family
Membership, the parent (s) or guardian(s) of
minor children, consent to their children
participating in
association activities and agree to assume
all responsibility for personal injury
and/or property damage to and by their
children.
Signature of Applicant:
___________________________________________
Date: ___________________
-Signature Required-
Activities conducted by the Central
Mountains All-Terrain Vehicle Association
Inc. are made possible through the
efforts of members who invest their time
and energy. A number of committees do exist
within our organization and if you would be
interested in participating on a committee,
please indicate below.
Yes
No
Be Alert…………….............Ride
Smart…………...............
Stay Safe |
