LAKE MOXIE ATV RIDERS CLUB

2025 Membership Application Form

$45.00 Primary Membership (includes spouse and children under 18)

$20.00 Secondary membership (already a member of another club)

$75.00 Supporting Business Member

Donation only option

**MEMBERSHIP FEE IS DUE APRIL 1 OF EACH YEAR**
Membership Type*

Primary Residential $45Secondary $20Supporting Business $75Custom donation
Name or Business name*
Spouse
Children
Address*
Town/State/Zip*
Phone*
E mail*
example@example.com
ATV/ Year/ Make
Associate Club(s)
Areas of interest
I understand that by signing this form, my membership can be discontinued at any time if the Lake Moxie ATV Riders or its officers have reason to believe that I, or a member of my family operates an ATV irresponsibly so that it endangers the landowner/Lake Moxie ATV Riders relationship; or if it is believed that the operator could cause harm to another individual. My membership fee is non- refundable, and will be used to support the Lake Moxie ATV Riders as a whole. I also agree to hold harmless the Lake Moxie ATV Riders from all liabilities resulting from my involvement with the Lake Moxie ATV Riders.
Signature

Clear
Date*

MonthDayYear
Date
Please make checks payable to Lake Moxie ATV Riders and mail payment to: Holly Towle P. O. Box 116 Caratunk, Maine 04925

If you have Club Questions please call: President Ben Towle: 207-861-1078 Vice Pres. Jim Benner: 629-9013 Trail Master Josh Benner: 446-6492 Holly Towle:Treasurer 441-6748 Secretary Karen Benner:
e-mails ben@mainelakesidecabins.com bennersaw@gmail.com

holly@mainelakesidecabins.com

Tread Lightly, Ride Safe, and Obey All ATV Laws on Public Trails and private land
Insert membership amount here. You can donate any amount*

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USD$45.00 Primary Membership (includes spouse and children under 18) $20.00 Secondary club Member $75.00 Supporting Business Member, or insert Custom donation amount
LAKE MOXIE ATV RIDERS CLUB
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