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Rangeley Lakes Snowmobile Club 2009-2010 Membership Form
Mail to: Rangeley Lakes Snowmobile Club PO Box 950 Rangeley, ME 04970-0950
Mail to:
Rangeley Lakes Snowmobile Club PO Box 950 Rangeley, ME 04970-0950
Please read the MSA membership and insurance information carefully! Family memberships are different than individual memberships:
Note: All membership plans will receive our monthly newsletter, the MSA newspaper, and club decal. If you wish to receive RLSC newsletter by e-mail, please indicate e-mail address below.
Platinum Club Membership - $102
Our Platinum Club membership entitles you to an individual membership in the Rangeley Lakes Snowmobile Club and the Maine Snowmobile Association (MSA) until September 30, 2010. You will receive our Platinum Club pin & baseball-type hat and MSA insurance.
Gold Club Membership - $62
Our Gold Club membership entitles you to an individual membership in the Rangeley Lakes Snowmobile Club and the Maine Snowmobile Association (MSA) until September 30, 2010. You will receive our Gold Club Pin and MSA insurance.
Regular Membership - $27
Our Regular Club membership entitles you to an individual membership in the Rangeley Lakes Snowmobile Club and the Maine Snowmobile Association (MSA) until September 30, 2010 and MSA insurance.
family Membership - $42
Our Family membership entitles you to membership for two parents and all children under the age of 19 living in your home in the Rangeley Lakes Snowmobile Club. You will receive 2 club decals and one Msa membership with insurance coverage. Your MSA membership will expire on September 30, 2010.
!!REMEMBER!!
Family membership includes One (1) MSA membership with insurance coverage. ALSO - Any MSA member may sign their dependents up under MSA for Dependent Insurance. List their full name and birth date and add $2.00 per dependent.
NAME ______________________________________
ADDRESS _______________________________________
CITY ____________________________ STATE ______
ZIP ____________
EMAIL ADDRESS ________________________________
BIRTH DATE ______________
BENEFICIARY ______________________________________
DEPENDENT'S NAMES (Add $2.00 each):
__________________________________________________
REFERRED BY (optional) ___________________________________
Gold Club - $62
Regular - $27
Family - $42
Please send my RLSC Newsletter via email instead of postal mail (be sure to include your email address).
Thank You!
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