Membership form

Please fill out and send to:

Agassiz Trail Riders ATV Club, PO Box 56, Karlstad, MN 56732

Name__________________________________________________________________________________________________________________________

Address_____________________________________________________________________________________________________________________

City__________________________________________________________________________St____________Zip_____________________________

County_______________________________________________________________________________________________________________________

Home phone (    )____________________________________________E-mail__________________________________________________

Membership (check one)___________________________________new _______________________________________renew

Date Joined___________________________________________________________ Dues expire March 31^st, annually.

*One-year individual or family membership is $25.00

Spouse’s name____________________________________________________________________________________________________________

Children & ages__________________________________________________________________________________________________________

* subject to change