Mount Moosilauke ATV Club
603-764-5541
2010 Membership Form
Date:_____________
Name:___________________________________________________
Mailing
Address:____________________________________________________
Street
Address if different:______________________________________________
City/Town:__________________________State____________Zip
Code:________
Email
Address:_________________________________________________
Phone:_________________________Local
Phone:______________________________
(if different)
______Single
Membership $15.00 ______ Family Membership $20.00
Additional
Donation $____________Total Amount Enclosed $ _________________
Make check payable to Mount Moosilauke
ATV Club
In order for the Club to offer events, we need members to help out. Please consider helping out at our events.
Check off events that you would be willing to help with.Participate
in Parades____Fund Raising____Organizing Rides______Trail Work______
Cookout/Picnic_____Selling
Raffle Tickets_______
I won’t be able to help at Club activities, but would like to help with a
donation of $____