Northfield Snowmobile Club, 13 Parker Ave, Northfield MA. 01360

LastName:______________________________________FirstName:_________________________

Address:______________________________________________________________________
(Street)                    (City)                                                     (State)            (Zip Code)

Phone:_________________________ New Applicant:________      Renewal:________

Membership - $55.00 Includes one (1) Trail Permit Decal.  (Each additional Trail Permits are $35.00 each.

Trail fund donation for trail work and supplies.                              $______________

Total AmountEnclosed.)                                                           $______________

Snowmobile #1 Information:

LastName:_____________________________________FirstName:__________________________

E-mail address______________________________________________

Year:__________  Make:_____________________________Model:____________________

Serial Number:__________________________________ State Reg.Number:_____________

Snowmobile #2 Information:

LastName:_____________________________________FirstName:__________________________

First Name:______________________________

E-mail address______________________________________________

Year:__________  Make:____________________________Model:_____________________

Serial Number:__________________________________ State Reg.Number:_____________

Snowmobile #3 Information:

LastName:____________________________________FirstName:___________________________

E-mail address______________________________________________

Year:__________  Make:___________________________Model:______________________

Serial Number:__________________________________ State Reg.Number:_____________

Please read and sign, signature is required to process application:
I, the undersigned waive all rights from accident or injury while riding on trails, or participating in any activities involving the Northfield Snowmobile Club, The Snowmobile Association of Massachusetts, any member club, private landowners, the Commonwealth of Massachusetts, or the individual townships of Massachusetts. I understand snowmobiling involves the risk of accident, injury or even death.

Signature:_____________________________________________________Date:___________

Trail permits will be sent upon receipt of signed application and full payment.  One-year membership runs Sept. thru Sept.  Thank you for your support