Application

Name:    Spouse's first name (if applicable)
Address:
City:     State              Zip + 4
Telephone:                                          Cellular:
Email address:                   Fax:

I was referred to the Webster County Wheelers by:

Select membership type:   Family - $30 ($15.00 to Webster County Wheelers - $15.00 OHV)
                                              Associate Member - $50 (not Iowa OHV Associate Membership)
                                              Donation (Additional donations are appreciated)
                                               (All memberships are on an Annual basis)

Please list first name and age of family members:
                               Name Age
                               Name Age
                               Name Age
                               Name Age
                               Name Age
                               Name Age

Make checks payable to Webster County Wheelers

Check all that apply: All Terrain Vehicle (ATV) Dirt Bike Snowmobile
Other:

Registration: The Webster County Wheelers strongly encourages its members to register their ATV’s, Dirt Bikes, and other OHV’s with the State of Iowa. Remember, your state registration provides funding for the OHV parks! Registrations are required to ride in any of the State’s OHV Parks.

Please read and sign:
I the undersigned, hereby make application for membership in the Webster County Wheelers. I agree to abide by all the rules and regulations as stated in the by-laws. I shall and hereby do, for myself, heirs, executors, administrators, and assigns, release, discharge and forever hold harmless, the Webster County Wheelers and it’s officers, the Iowa OHV Association Inc., the Iowa Partners of NOHVCC, the State of Iowa, the U.S. Army Corps of Engineers, other local clubs, county and city governments and land owners from any and all claims or liabilities directly or indirectly as result of all injuries (Including Death) and or accidents to or caused by myself while engaged in any form of off road riding, (Including all types of OHV's) riding any motor vehicle, or any other activities performed by myself in connection with the Webster County Wheelers and it’s officers, the Iowa OHV Association, Iowa Partners of NOHVCC Inc. and all other aforementioned government offices, and free said parties for any responsibility therewith. I also certify that I am 18 years of age or older. If under 18, I must have parental consent.