New Durham Valley ATV Club

P.O. Box 441, New Durham, NH  03855

 APPLICATION FOR MEMBERSHIP – YEAR 2008

Please complete the following information and return with the necessary fee.

Name:________________________________

Street Address/P.O. Box:___________________________________

City/Town:________________________       State:_______________          Zip Code:___________

Home Phone:______________________        E-Mail:_____________________________________

Renewal or New Membership (Please circle one)

Individual Membership (Any person over the age of 18)                         $15:__________

Family Membership (Includes dependents under the age of 18)              $25:__________

            *Dependents over 18 must apply for single membership*

            LIST FAMILY MEMBERS:_________________________________

            _________________________________________________________

PLEASE LIST TYPE OF MACHINE(S)

           YEAR                           MAKE                         MODEL                      COLOR                REGISTRATION

***NOTE***  By Joining New Durham Valley ATV club you are automatically becoming a member of NHOVA                                                                                     

Optional Donation:__________

                                                                                                                   Total Enclosed:__________

By signing below I/We are stating that we have read and agree with the Club Bylaws.

________________________________________                            ____________________

                        (Signature)                                                                                   (Date)

**By signing this application, I accept sole responsibility for any injury and/or damages, which may result from my or any family member involvement in club activities.  I further agree to hold harmless the club from all liabilities.**