The New Adirondack Riders Snowmobile Club

P.O Box 125

Whitehall, NY 12887

www.newadirondackriders.org

thenewadirondackriders@yahoo.com

 

 

First Name (print only)_____________________________________________________

 

Last Name_______________________________________________________________

 

Street Address/PO Box_____________________________________________________

 

State_______________ Zip Code_____________________________________________

 

Spouse First Name_____________________ Last Name__________________________

 

Children under 18 who intend to register sled in their own name______________________

_____________________________________________________________________

 

Phone #_________________________________________________________________

 

Email___________________________________________________________________

 

Number of sleds registered__________________________________________________

 

(   )               Twenty five cents of your $5.00 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 the box.  Please note, your NYSSA dues remain $5.00.

 

Membership dues for 2007-2008 for single and family are $25.00

 

Terry Bessette-President   Craig Monty-Vice President

Club Use Only

Bland Voucher ID issued:_________________________________________________

 

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