NORTH QUABBIN ATV ASSOCIATION
MEMBERSHIP
APPLICATION
General and Family Membership: $25.00
NQATV is family orientated
and membership covers your immediate family, regardless of your situation.
Date: /
/ . Age: Date
of Birth: / /
.
Name: Home Phone:
_________________________
Street
or PO Box: ______________________________________________________________
Town/City: State: Zip: ______________
E-Mail
Address:
.
In
Emergency Notify: Phone:
________________________
Do
you have any EMT, CPR or First Aid Training?
Yes No
__________
Any
other valuable training? ______________________________________________________
ATV
Make: ATV Model:
____________________________Year:
ATV
Make: ATV Model:
____________________________Year:
ATV
Make: ATV Model:
____________________________Year:
Family
Information:
Spouse
or Significant Other: Age:
_______________
Children
(under 18 years old):
Name: Age:
________________
Name: Age:
________________
Little Pond Farm sponsors
North Quabbin ATV Association. The main
trail riding systems are on private authorized lands. All members are encouraged to enroll into Western Mass ATV
Association also since many of our rides are with them. It is expected that you help out with Western
MA state forest trail maintenance at least one day a year. The club’s goal is for all to be registered
riders, wear proper safety gear, promote the club in good manner, have fun, and
pursue the goal of state and private lands to ride on in Central Massachusetts.
A club logo will be mailed
to you along with club information upon receiving membership application. Club apparel is available for
purchase. For more info call Bill Suzor
978-575-0680
Make Check or Money Order
payable to Bill Suzor.
Little Pond Farm
North Quabbin ATV Association We look forward to meeting you soon and
54 Sentinel Elm Road Thank
you for joining