West Nipissing ATV Club / Nipissing Ouest Club de VTT

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West Nipissing ATV Club

2012 Online Membership Registration

A member of the W.N. ATV Club VTT N.O. must possess an ATV driving license and/or a valid driver’s license

Membership Form
Please fill out the form and submit.

Name *

First

Last

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Email

Confirm Email

Home Phone Number *

###

####

Work / Cell Number

###

####

Date of Birth *

YYYY

You must be 16 Years old or older with a valid G License to join.

Membership *

New Membership

Renewal

Checkboxes *

I authorize my NAME, PHONE # and E-MAIL ADDRESS to be distributed

I do not wish my name to appear on the club website.

We need this authorization from you to post your info on the club's Memberlist AVAILABLE TO CLUB MEMBERS ONLY.

If you selected "I do not wish my name to appear on the club website." other members will not have your info to invite you to rides and such.

I accept the terms and conditions of the West Nipissing ATV Club. I certify that I am over the age of 16 with a valid Drivers license. *

I Accept