P.O. Box 353 Parry Sound, ON
Canada P2A 2X4

2010 Membership Registration Form 

 FIRST NAME:  ____________________  LAST NAME: ______________________

 ATV CLUB NAME:   Parry Sound ATV District Club

 STREET: _________________________________________  APT/RR#: ______

 CITY: _________________  PROVINCE: __________ POSTAL CODE: __________

 PHONE #: (Work)_______________   (Home)___________________________

 FAX #:____________________  E-mail: ______________________  

 Signature:___________________________

 Full Membership (voting) available for $50.00 (expires December 31, 2010)

 Please forward your completed form, payment in cheque/money order to:

Parry Sound ATV District Club
P.O. Box 353
Parry Sound, Ontario P2A 2X4
Tel: 705 774-9778  Fax: 705 389-1625
e-mail:  info@psatv.ca      Web Site: psatv.ca

Please make cheques payable to: “Parry Sound ATV District Club”