North Country ATV Association
N.Y.T.R.O. of Eastern NY
Membership Information and Application
Individual membership is $100.00 per year Due September of every year
Family membership is $125.00 per year Due September of every year
Former members not legible for pro-rate
Membership pro rate; September to May Individual $ 100.00 Family $125.00
June to August Individual $150.00 Family $175.00 June to August fee includes the follow year
Please check one riding Membership______ Hunting Membership only__________
Name:_____________________________Address:___________________________
City:________________ State:________ Zip Code___________________
Phone:_______________ Date__________ E-Mail:____________________________
Machine Information
Year:_______ Make:_______________ Model:________________ CC:_________
Year:_______ Make:_______________ Model:________________ CC:_________
Use back if more room is needed for machine info
Family Membership Information; Spouse’s Name:____________________
Children under 18 years of old
1st _____________ 2nd ______________3rd________________4th______________
Please include a copy of your registration and Insurance card with your check
Payable to NCATVA
Parking is done on private property so please make sure your parking permits get put in window of tow vehicle
Tow vehicle info
1) Plate #;__________________ 2) Plate #;________________3rd Plate #___________________
North Country ATV Association NYTRO of eastern NY PO Box 136 Greenfield Center NY 12833
All information pulse membership waver must be completed and signed for application to be accepted
I agree to up hold all of North Country ATV Association NYTRO of Eastern NY a Division of NYTRO Inc.
Rules and Regulation.
Signed:________________________________Date____/_____/_____
Please include a copy of your registration and insurance card signed weaver
with your check payable to NCATVA.
Membership to NCATVA / NYTRO east only gives you the right to use the 1506 acers of land that the club leases.
Your application will not be accepted unless the following Waiver and Release is signed.
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North Country ATV Association NYTRO of Eastern NY a division of NYTRO Inc.
Waiver and Release
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I,
the applicant (Releasor), being at least 18 years of age or the parent
or guardian of a minor, in consideration of being permitted to become
members in the NORTH COUNTRY ATV ASSOCIATION NYTRO OF EASTERN NY A
DIVISION OFNYTROE INC. and ANY of its Chapters (Releasees), WAIVE,
RELEASE, and DISCHARGE the Releasees, officers, directors, employees,
members, land owners, agents, assigns, legal representatives and
successors, any business associates and partners involved in the
membership of the above noted Club or its chapters, from all liability
for or by reason of damage, loss or injury to person and property, even
injury resulting in the death of the Releasor, which has been or may be
sustained in consequence of the Releasor’s participation in Club or
Chapter membership, rides, outings, or activities, and notwithstanding
that such damage, loss or injury may have been caused solely or partly
by the negligence of the Releasees.
I
hereby acknowledge and agree that I have carefully read this Waiver and
Release, that I fully understand same, and that I am freely and
voluntarily executing same. By signing this Waiver and Release I will
be forever prevented from suing or otherwise claiming against the
Releasees for any property loss or personal injury that I may sustain
while attending and/or participating in any activities involving the
above noted Club or one of its chapters OR Land Owners.
I
acknowledge that I am informed and understand both the major (up to and
including death) and minor hazards and risks associated with my
membership, participation and/or attendance. I understand, accept and
assume those hazards and risks of off road recreation. Therefore, I
have determined whether I have adequate separate personal insurance to
cover all harm that my family or I may suffer due to attendance or
participation in any Club or Chapter related activity and I have
personally obtained all insurance protection that I want.
I
understand that I will not be permitted to become a member of the above
noted Club and Chapter unless I sign this Waiver and Release.
I
HAVE READ AND UNDERSTAND THIS WAIVER AND RELEASE AND I AM AWARE THAT BY
SIGNING THIS WAIVER AND RELEASE I AM WAIVING CERTAIN LEGAL RIGHTS WHICH
I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY
HAVE AGAINST THE RELEASEES.
Name
of each family member: (Do not sign unless you are age 18 or older. For
family memberships, at least one of the applicants must be age 18 or
older, and a parent or guardian must sign for family members under the
age of 18.)
_________________________ ______________________________ ___________
Print Name Signature Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
_________________________ ______________________________ ___________
Print Name Signature of Parent or Guardian Date
