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A P P L I C A T I O N

Welcome to the Chickaree Ridge Runners Snowmobile Club Family!

The dues will be:

$10.00 for Single Membership
$15.00 for Family Membership (includes husband, wife and all children under 18)

Your membership dues will be collected between December 1 and January 31.

Please make checks payable to: Chickaree Ridge Runners Snowmobile Club

Please enclose check & send membership application to:

Chickaree Ridge Runners Snowmobile Club
763 Pike Road
Johnstown, PA 15909

Please print and fill out ALL information clearly and completely:

Check ONE:     Family Membership    Single Membership

Name: _________________________ Spouse's Name: _______________________

Address: (Street) _______________________________________________________

(City) ___________________________(State)__________(Zip)___________

Phone #: _______________________________

Email address: ______________________________________

Children: ___________________________ Age: ____ Date of Birth: ______________

Children: ___________________________ Age: ____ Date of Birth: ______________

Children: ___________________________ Age: ____ Date of Birth: ______________

Children: ___________________________ Age: ____ Date of Birth: ______________

NOTE: Anyone entering the Clubhouse grounds on the day of a snowmobile event (where a donation is being collected) MUST pay gate fee, unless the person is working a station at the event.