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