Harvard Snow Gophers

2008 - 2009 Season

Membership Application

Choose one:
New Membership - $30.00     Renewal  Membership  - $30.00     If renewal, how many years as member?

Note: $7.50 of your club dues pays for your IASC membership and your subscription to Illinois Snowmobiler Magazine.

Member information:

Name:  
Address:
City:   State:   Zip:
Phone: 
E-Mail: 

Family members:

Spouse Name:
(if applicable)

Name: Age: Safety Certificate #:
Name: Age: Safety Certificate #:
Name: Age: Safety Certificate #:
Name: Age: Safety Certificate #:

I will be willing to participate in the following?  Board member     Trail work     Club Activities     Club Fundraising

You are required to carry insurance on all sleds which will operate on the trails. You will need to show proof of insurance for each machine to receive your trail sticker.

Insurance Co.
City:               State:
Phone:      

Snowmobile information:

How many Snowmobiles do you own:


1.Make/Model: Registration # State:

     Policy#

2.Make/Model: Registration #  State:

    Policy #


3.Make/Model: Registration #  State:

    Policy #


4.Make/Model: Registration #  State:

    Policy #


5.Make/Model: Registration #  State:

    Policy #

If accepted for membership, I agree to abide by the rules, regulations, and By-Laws of the Harvard Snow Gophers Snowmobile Club and hold the Club, its officers, and members harmless in the event of personal injury, property damage, or death during any Club event or activity. I further agree to maintain personal liability insurance on my snowmobile(s).

Member Signature: _____________________________________

Note: As you are required to include payment with this application, we cannot process your membership without a printed copy. You must fill this form out online click Print  and then Submit Form.

When you are finished, print and mail this form.
Please include copies of your insurance cards with your membership applications.
Checks should be made out to: "Harvard Snow Gophers" and mailed to:
Harvard Snow Gophers Snowmobile Club, 21517 Dunham Rd. Harvard IL 60033

(Please do not forget your signature).

Mail it to the above address, along with your payment.