Name:     _____________________________________________________________________________


Address:    ___________________________________________________________________________


 City:          ___________________________________________________________________________


 State:        _________________________________Zip Code___________________________________


Email Address: ________________________________________________________________________


Phone Number:  Home:________________________ Cell: ______________________________________


Vehicle Make:  _____________________     Model: __________________   ATV [  ]     UTV  [  ]


Individual/Family Member $20.00     [  ]                                                                  $_____________ 


Business Member $40.00   [  ]                                                                                $_____________


Map Ad (Includes Business Membership)  $150.00                                                $_____________

(Please include a camera ready or printable proof of your ad)


Double Map Ad    $ 200.00                                                                                      $_____________


Donation:                                                                                                                 $_____________


Total Enclosed:                                                                                                        $_____________


Please use my map ad that was on the map last season. Please Check [  ]

Please Check [  ]  I understand that by joining the St. Germain ATV Club Inc. I will abide by all the rules

and bylaws of the club. I also agree to follow all State of Wisconsin ATV laws and regulations, and that I will

drive responsibly.


Signature: _________________________________________________________     Date: _______________________


Membership dates are from May 1st through April 30th of each year.

Please cut and paste this application form, print it,  and mail it with your check for the proper amount to:

St. Germain ATV Club Inc.

PO Box 161

St. Germain WI 54558.


St. Germain ATV Club