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Membership

2011 Membership #:

Transponder #:

First Name:

Last Name:

Address:

Apt #:

City:

Province:

If other above:

Postal Code:

Date of Birth:

Age:

Email Address:

Day Phone:

Evening Phone:

Motorcycle Year:

Motorcycle Make:

Motorcycle Model:

Requested Bike # 1st Choice:

Requested Bike # 2nd Choice:

Requested Bike # 3rd Choice:

I would like to receive information
from MMRS Sponsors

Motocross
Please Select Your Classes:

50 A
50 B
50 GP
60 A
60 B
80 A
80 B
Super Mini
Schoolboy
MX Tykes

Novice A
Novice B
Junior A
Junior B
Open Novice
250 Novice
Open Pro
Open 250

Ladies A
Ladies B
Expert
Over 30A
Over 30B
Over 40A
Over 40B
Senior

ATV
Please Select Your Classes:

ATV Mini 4-8A
ATV Mini 4-8B
ATV Mini 9-12A
ATV Mini 9-12B
ATV Super Mini 9-12
ATV Super Mini 4-8

ATV Junior (13-16)
ATV C (+16)
ATV B (+16)
ATV A (+16)
ATV Ladies (+13)
ATV Mini Tykes

ATV +30A
ATV +30B
ATV OPEN A & B
ATV OPEN C & Junior

Pay by Paypal

Membership Plan:

Security Code: CASE SENSITIVE

MEMBERSHIP FEE
1 Year Membership	SINGLE $75.00
Early Bird - until March 31, 2012	*FAMILY $120.00**
1 Year Membership	SINGLE $85.00
After April 1, 2012	*FAMILY $140.00**
* Family includes all immediate family members 18 years or under, students 18 years - 21 years. * Membership gets you into all MMRS events for $5.00 and each membership is allowed one guest for $5.00

Payment can be submitted by
CHEQUE	Make cheque out to: MMRS Mail to: M.M.R.S. J. Maguire 1224 Centreton Rd. Grafton, ON K0K 2G0
CASH	Please bring cash payments to us.
PAYPAL / DEBIT / CREDIT CARD	Pay with PayPal/Debit/Visa/Mastercard via PayPal If you do not have a PayPal account, you can click the PayPal link and then select to pay as a PayPal guest.