Name:     _____________________________________________________________________________

Address:     ___________________________________________________________________________



Phone Number:            Home:________________________ Cell: _____________________________

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

Individual/Family Member $20.00     [  ]                                                                  $_____________ 

Business Member $40.00   [  ]                                                                                $_____________

Donation:                                                                                                                 $_____________

Total Enclosed:                                                                                                        $_____________

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