MEMBERSHIP APPLICATION

LEWIS-CLARK ATV CLUB, INC

PO BOX 2021
LEWISTON, IDAHO 83501-2021

lewisclarkatvclub@gmail.com

Year paying for_________ Membership#_________

Date: _______________________________

 Member Information:

Member Last Name (Print)

 

First Name (Print)

Spouse (Print)

Street Address (Print)

 

 

 

City (Print)

 

State (Print)

Zip

Home Phone

 

Work Phone

Cell/Mobile

 

E-Mail Address 

 

 

 

Sponsoring Member and Number

 

 

 

 ANNUAL MEMBERSHIP DUES (VALID CALENDAR YEAR JAN-DEC):

 [  ] Individual $15 per year (18+ years)      [  ] Family $20 per year (children 18 & under)

 Please make check payable to Lewis-Clark ATV Club, Inc.

 IMPORTANT WAIVER

(Please read and initial each statement)

In consideration of the acceptance of my membership fee:

 _________________I/We recognize that riding an ATV is a hazardous activity that can result in serious personal injury or death.  I/We accept the risks inherent to riding with a group including, but not limited to, obstacles on and off the roads and trails, rapidly changing weather, limited visibility, variation of slope and steepness on and off the trails or sub-surface conditions on and off the trails and roads, collisions with other ATV’s including other rides and collisions with devices used to mark the boundary of trails or roads.

_________________In consideration of my/our participation in the events and rides of the Lewis-Clark ATV Club, Inc., I/We hereby release and agree to hold harmless the Lewis -Clark ATV Club, Inc., their officers, directors, committees, employees, volunteers and agents from all claims.

_________________I/We have carefully read this agreement and the release of liability and fully understand its contents.  I/We are aware that this Release of Liability is a contract between the Lewis-Clark ATV Club, Inc., and myself/us, and I/We sign of my/our own free will.  My/Our signify that I/We have read and agree with this release.

 

 

Member Signature                                                               Spouse Signature


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