Application for Trailblazers' Membership

Richmond Trailblazers Snowmobile Club: Application for Membership 2009-2010
*Please print out this application or click here for printer friendly Richmond Trailblazer's Application.pdf
Please be sure to sign the insurance agreement before turning in.
Bring it with you to our next meeting.
We meet at the Barry's Bar & Grill (formerly American Legion Hall) in Genoa City, Wisconsin
on the 1st and 3rd Thursday of each month at 7:30pm Oct-April
Hope to see you at our next meeting!

Date___________

To the officers and members:

I, the undersigned, hereby petition for membership in the Richmond Trailblazers Snowmobile Club.

If accepted, I agree to conform and abide by the constitution and by-laws of this organization.

Name__________________________Signature_________________________

Spouse_________________________Signature_________________________

Present Address___________________________________________________

________________________________________________________________

Home Phone(_____) ___________________________Daytime Phone(___)________________________

Please PRINT your email address clearly ___________________________________

To ensure receiving club emails email your address to Maggie funnyfarmer@wonderwave.net

Children (ages 18 and under)

Name and age____________________ Name and age____________________

Name and age____________________ Name and age____________________

Number of snowmobiles owned________

I, the undersigned, hereby declare that I have snowmobile insurance with the following company
and will keep my insurance current throughout the entire 2008-2009 snowmobile season.
I assume all responsibility and will not hold the Richmond Trailblazers Snowmobile Club
responsible or liable for any accidents, injuries, or any harmful outcomes.
Declaration of Insurance:
Signature & date required: _________________________________Date:_______________

Insurance Company________________________________________________

Address__________________________________________________________

Policy #__________________________________________________________

How did you hear about the Richmond Trailblazers? (Newspaper, Magazine, referral, etc.)