Just print out the form below and mail it to the specified address

Name:_______________________________

Address:__________________________

City:________________________

State:_________________

Zip:________________

Phone: (207)______-_________

E-Mail Address:_________________________________________

Birthdate:______________________

Beneficary for MSA Ins.:________________________

Relationship:______________________

Additional Dependants (if applicable):___________________________________________________

YEARLY DUES ARE ONLY $28.00

Includes $2,500 Life Insurance from The Maine Snowmobile Association

Additional dependants Insurance available at no additional charge

Business Memberships Available for $50.00

Please Make Checks Payable To:

Hillside Family Riders S. C.
P.O. BOX 7044
Lewiston, Maine 04243-7044