Membership Application

Is This?

New Membership

Renewal

Name

First

Last

Name (Co-Applicant)

Street Address*

City*

State

Postal / Zip Code

Country

Email address*

E-mail (Co-Applicant)

Phone Number*

Phone Number (Co_Applicant)

Subscriptions *

Family ( $ 30.00 for each year.)

Business ( $ 100.00 for each year.)

Lifetime ( $ 500.00 one-time payment.)

I agree to the terms*

Yes

I agree to the terms (Co-Applicant)

Yes

This field should be left blank

Family

Family $30

Includes you & 1 adult plus children under the age of 18

Business

Like Family Membership plus your business card & Logo is promoted on our web site for 1 year

Lifetime

Like Family Membership & the main applicant is a member for life, including co-applicant and your children under the age of 18

Print the application then

1. Mail a payment to: HAVASU SXS TRAIL ASSOCIATION, PO Box 481, Lake Havasu City, AZ 86405-0481

2. Pay via PayPal to: Havasusxs@gmail.com