Roxbury ATV Riders Club Application
2019 Membership Application
First Name *
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Last Name *
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Street Address and City & State & zip *
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Phone Number *
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Email *
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Type of Membership *
Names of additional family members if this is a family membership
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Name of associate atv club (if associate membership)
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If any member is between the age of 10 and 16, please provide their ATV Safety Card #
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Are you interested in any volunteer opportunities? *
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DISCLAIMER I understand that by signing this form, I agree to abide by the ATV laws of the State of Maine. I also understand that my membership may be discontinued at any time if the club or its officers have reason to believe that I, or a member of my family operate an ATV irresponsibly so as to endanger landowner/club relationships, or it is believed that the operator could cause harm to another individual or property. I understand that my membership fee is non-refundable and it is intended to be used to support the club as a whole. I also agree to hold harmless the Roxbury ATV Riders Club from all liabilities resulting from involvement with the club.Electronic Signatures. This Agreement may be executed by providing an electronic signature under the terms of the Electronic Signatures Act, 15 U.S.C. SS 7001 et. seq., and may not be denied legal effect solely because it is in electronic form or permits the completion of the business transaction referenced herein electronically instead of in person. Please type your name below to agree to the terms laid out in this membership form. *
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Signature *
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Payment You will not receive a membership card or become a member until you complete the payment. We thank you very much for supporting our club and helping making ROXBURY GREAT AGAIN!
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