Application & Renewal

 Date: ___________________                      ___ New Member   ___  Renewal

Family or Individual:

Last Name: _____________________   Child: ______________  Child: ______________
First Name: _____________________   Child: ______________  Child: ______________
Spouse:  _______________________   Child: ______________  Child: ______________
                                                         
Additional: _______________________________
Address: ____________________________________________________________________
City: _____________________________ State: _________  Zip:  ________________
Phone: ______________________________  Cell Phone: ________________________
Email: ______________________________________________________________________

Company:

Company Name: ________________________________ Contact: __________________
Address: _____________________________________________________________________
City: _______________________ State: __________ Zip Code: ___________________
Phone: ____________________________  Cell Phone: ___________________________
Email: __________________________________________________________
Web Address: ________________________________________________________________

Dues:

_____ Individual Membership $25    _____ Sponsor Membership $50
_____ Family Membership $35        _____  Other _______________

Total Contribution:  ________________________

PayPal ID:  ____________________________

Mail or Fax Applications:

Timp Ridge Runners Snowmobile Club
10194 N. Cottonwood Dr.
Cedar Hills, UT  84062
Fax: 801-227-5021