BRAZEAU A.T.V. CLUB

                            Box 7095

              Drayton Valley, AB

          T7A 1S4

             www.members.shaw.ca/brazeauatvclub

      
           Membership Form

Name:____________________________________

Phone:  ________________ Cell:  ________________

Address:  ______________________________________

            ______________________________________

Postal Code:  ____________________

ATV Model:  ____________________

Comments:  _____________________________________  ____________________________________________________________________________________________

_____  $20.00 Single membership (17 years and up)

_____  $40.00 Family membership (includes children 16 and under)

_____ $100.00 Corporate membership (includes membership for 6 employees) 

Watch the website for meeting dates.
 

Signature:  ________________________

Date:  ____________________________

e-mail address:_____________________