Membership Application

Please Print

Please print this application and mail to:

Trailblazers Off Road Club
P.O. Box 383
Independence, IA 50644
Name Membership type:
Address ____Sponsor $35.00
City County ____Single $10.00
State Zip ____Family $15.00
Telephone No. in Family ____
Make Model No. Owned ____
Email address  
I would like to receive my newsletter by ____ email or ____ regular mail  
Signature(s) Date
  New ____
  Renewal ____
   

The Trailblazers have voted as a club to add Iowa OHV membership and dues to ours. We do this to help support our sport on a state level and to show the growth and popularity of our sport in the state. Be sure to fill out both membership forms. You only need to write one check for both memberships and we will handle the paperwork for you.

Name Membership type:
Address ____ Single $15.00
City County ____ Family $15.00
State Zip No. in Family ____
Telephone ____Associate $50.00
  ____New
____Renewal

I/We the undersigned, hereby make application for membership/renewal of my/our membership in the Iowa OHV Association, Inc. I/We agree to abide by all the rules and regulations as stated in the Association's Articles of Incorporation and by-laws. I/We shall and hereby do, for myself, my heirs, executors, administrators and assigns release, discharge, and forever hold harmless, the Iowa OHV Association Inc., the Iowa Partners of NOHVCC, the State of Iowa, the U.S.Army Corps of Engineers, local club, county and city governments from any and all claims of liabilities directly or indirectly as a result of all injuries (Including Death) and or accidents to or caused by myself while engaged in any form of motorcycling (including all types of OHVs), riding any motor vehicle, or any other activities performed by myself in connection with the Iowa OHV Assocation, Iowa Partners of NOHVCC, and all other aforementioned government offices and free said parties for any responsibility therewith. I/We also agree to hold harmless the owners of any property that I/we may cross during my/our activity for any losses or injuries (Including Death). I also certify that I am 18 years of age or older. If under 18, I must have parental consent.

Signature of Applicant _______________________________________ Date __________

Signature of Family Members ___________________________, ______________________, _______________________, _______________________, ______________________

Signature of Parent _______________________________________