╨╧рб▒с > ■ ■ ¤ ■ ■ ■ ■ R o o t E n t r y ┬█═(т ╬вЪ к Jr А Ьl╧N╞ └ M a t O S T роil╧N╞а@Лl╧N╞ M M M N 0 ■ ■ ND ■ ┬█═(т ╬вЪ к Jr Microsoft Works MSWorksWPDoc Ї9▓q M a t a d o r O b j e c t 0 а╓rl╧N╞а╓rl╧N╞ C o m p O b j U Q g i Л Н A ¤ А Щ ф ц {ri`\V\r`\V\V\{ И Ш Ш . C Q l К и g i Н н ╛ └ qqggggggg]g]gg]] р└! ■ХSё ё а░TЫ ╨ ц / Еьа р=╨/ e ь d ╨ ф tг O T Brettuns Wheelers ATV Club P.O. Box 673 Livermore, Me 04253 207-897-9535 ____$20.00 Single Membership ____$25.00 Family Membership ____$35.00 Supporting Business Membership All membership fees include ATV Maine Membership ( if already a member subtract $5 ) 2006 - Club Membership Application New___ Renewal___ Date___/___/___ Club Membership Year: 06/01/06 to 06/01/07 Name_______________________________________________________________________ Address_____________________________________________________________________ Town, State, Zip,_______________________________________________________________ Phone Number______________________________e-mail______________________________ Do you belong to another club ATV or Snowmobile?____________________________________ List all family members under membership Spouse______________________________________________________________________ Child1_______________________________________________________________________ Child 2_______________________________________________________________________ Child 3_______________________________________________________________________ ATV/Year/Make_______________________________________________________________ Areas of Interest: __Trail work + any equipment __Landowner relations __Safety training __Search+Rescue __Boards/Committees __Fundraising __Activities/Events __Help where needed How / where did you hear about the ATV Club? _______________________________________________________________________________ I understand that by signing this form, my membership can be discontinued at any time if the club or its officers have any reason to believe that I or any of my family operates an ATV irresponsibly so that it endangers the landowner/club relationship or if it is believed that the operator could cause harm to another individual. My membership fee is non-refundable and is intended to be used to support the club as a whole. I also agree to hold harmless the ATV Club from all liabilities resulting from my involvement with the club. Signature:____________________________________________Date:___/___/___ Meetings are held at 971 River Rd, Livermore 2nd and 4th Tuesday of every month Meetings start at 7:30pm Please come to our next meeting or mail this form to: P.O. Box 673 Livermore ME 04253 Please make checks payable to Brettuns Wheelers ATV Club /01/06 Name___________ Q g i Л Н A ¤ А Щ ф ц {ri`\V\r`\V\V\{ И Ш Ш . C Q l К и g i Н н ╛ └ qqggggggg]g]gg]] р└!└ я ё > М ▐ . Д Ж ░ ■ M Э э я ? ]]]]]]]]]]]]]SS ! Ё ? A U ¤ - ~ А Щ Ы у х 7 Q И Ц к ф ц uuuuuuuuuuukkkkkkk ц └ ? ц Times New Roman Arial CAC Logo Alternate ╨╨ Е ь а р= ╨/ e ь Е ь а р= ╨/ e ь d