Membership Form
 

 


Genesee Sno-Packers Snowmobile Club Inc.

www.geneseesnopackers.com

Membership Application for 2011 – 2012 year

Mail to: PO Box 62 Oakfield, NY 14125

                                                       

Type of Membership:                         NSSSA ID Number ____________(# on Membership Card)                     

[  ]  Single (one person) $30.00                           Have you already paid NYSSA Dues this season via another club? ____________ 

[  ]  Family membership $30.00                           If so, deduct $5 and enter name of club__________________________________ 

[  ]   NYSSA Trail Defender membership additional $20 Total amount enclosed___________________

[  ] NEW! Donation to club in lieu of volunteering additional $25/$50/$100 (CIRCLE ONE) 


First Name: ________________________________             Last Name: ________________________________ 

 

Spouse: ___________________________________            Email: ______________________________________________________

                                                                                                                                               {DMV Voucher, NYSSA Newsletter and other information can be emailed}           

 

Address:  __________________________________           Phone Number: _____________________________

 

Town/City: _________________________________          Zip: ______________________________________

 


  Please list all riders under the age of 18 that intend to register a snowmobile:

 

1. _________________________age________                          3. __________________________age________

 

2. _________________________age________                          4. __________________________age________

 

Liability Disclaimer:

            I will be responsible for myself and any passengers and assume all risks and liabilities in the event of an accident, fire, and theft to myself, my equipment or vehicle.  I will not hold the Genesee Sno-Packers Inc. or landowners responsible in event of injury or damage.  I will follow and obey all New York State laws involving snowmobiles.  I have read the NYS General Obligation law 9-103 and understand that snowmobiling is a dangerous activity, which can result in injury or death. 

 

Trail conditions vary constantly because of weather changes and snowmobile use.  I also understand that ice, variations in terrain, moguls, rocks, forest growth, debris and other obstacles and hazards, including other snowmobiler's, exist throughout the area.  I will not make a claim against Genesee Sno-Packers Inc., landowners, officers or members.  I submit this application and promise to comply with all current and future rules and regulations of the Genesee Sno-Packers Inc. Snowmobile Club.

 

[  ]  Twenty five cents of your $5 NYSSA dues will be used for the NYS Snowmobile PAC (Political Action Committee) who is our voice in Albany.  If you do not wish to contribute to the NYS Snowmobile PAC, please check this box.  Please note, your NYSSA dues remain $5.00.

 

Members must be 18 years of age or older to sign disclaimer. Signature: _________________________________

                                                                                                           

Number of Snowmobiles being registered:  ________  

  • Membership runs from August 1st, 2011 through July 31st, 2012
  • Application may be mailed to the address listed or turned in at monthly meetings

This is not the voucher form required by the DMV

 

 
 
Voucher Number: _______________________                           Paid by Check _________ or Cash