Deerfield Valley Stump Jumpers Snowmobil Club, Vermont snowmobile clubs

Deerfield Valley Stump Jumpers Snowmobile Club, Inc.

Membership 2006/2007

(TMA) Trails Maintenance Assessment

Instructions: Please fill this form out completely, all areas with an * must be completed. Once completed please print this page. Please mail your printed form and payment due to address below. If you make a mistake or wish to change this form before sending it, click the "Reset" button. Once your Payment is received your TMA and membership packet will be sent to you. Thank you for joining our club.

(Note to Members: A copy of your Current Vermont property tax bill and Current Vermont snowmobile registration must accompany your application to receive a Vermont Resident T.M.A.)

Please check type of TMA Requested: Non-Vermont Resident ($115.00 )

Vermont Resident ($85.00)

Name of Registered Owner: *

Name of Club Member: *

Address: *

City: * State: * Zip Code: *

e-mail address:

Year of Snowmobile: * Model: *

Manufacturer: *

Serial Number: *

Registration Number: *

State/Province of Registration: *

Other Items Available for Purchase
Please check box for each item wanted

Club Trail Map.....................................................................$5

Quantity wanted

GROOMING FUND

Donations are greatly appreciated for our Grooming Team and will help to ensure that our trail system is
maintained on a regular schedule.

Grooming Team Donation $

Please Enter Total Amount Due....................$ *

By signing below, you herby agree to the following liability statement

LIMITED LIABILITY STATEMENT

As a member of a snowmobile club I, the undersigned, owner of the snowmobile described above, declare that I am liable for the use of a trail in conformance with the snowmobile laws and rules of the State of Vermont. Without limiting the generality of the foregoing, I declare that I am well aware of the risks related to the presence of tree branches, stones, and soil on the trail as well as the risks related to the maintenance and signing of a trail. I consequently declare that I deny my own recourse to any damage, be it of any kind, that could happen to me in the use of a trail.I also pledge that I will inform any person to whom I would lend or rent the snowmobile that I own, of the risks above mentioned and will advise them that the association, the club, or the owner of the trail do not assume any responsibility for the damages they could undergo while using a trail.

Date Signed______________________

Signed__________________________

PRINT THE FORM USING YOUR YOUR BROWSER

MAKE ALL CHECKS PAYABLE TO:

DVSJ

MAIL THIS FORM AND CHECK TO:

DVSJ
P.O. Box 1329
Wilmington, VT 05363

Submission of this form constitutes that the permit purchaser agrees to the conditions as printed on the TMA and herby agrees that all information submitted is true and correct.