Membership Application

Please print out this application and bring it, filled out, to one of the Esprit de Four club meeting. The application can be turned in to the membership chair. Please review the membership links above and see Meeting Info for meeting details.
Print

Name:	__________________________________________________
Spouse/Partner Name:	__________________________________________________
Child Name(s):	__________________________________________________
Membership Type:	Single Family Friend
Rig#1:	__________________________________________________
Rig#2:	__________________________________________________
Home Address:	__________________________________________________ __________________________________________________
Home Phone:	(______)___________________________________________
Mailing Address:	__________________________________________________ __________________________________________________
E-Mail Address:	__________________________________________________
Work Phone:	(______)______________________OK to call Yes No
Cell Phone:	(______)___________________________________________
Pager Phone:	(______)___________________________________________
Fax Phone:	(______)___________________________________________

On this date, I do hereby apply for membership to Esprit de Four. Upon acceptance, I agree to follow all rules, by-laws and policies of the club; pay any and all dues necessary in a timely fashion; maintain minimum required insurance on all vehicles; operate my vehicle in a safe and sane manner; and abide by the tenets of Tread Lightly. By signing below, I do hereby state to have read and fully understand the above.

Signature: ___________________________________________ Date: ________

FOR CLUB USE ONLY

Club Meetings:	#1 Date:	_______________	Club Runs:	#1 Date:	_______________
	#2 Date:	_______________		#2 Date:	_______________
	#3 Date:	_______________		#3 Date:	_______________

Membership Initiation Date:		_______________
Fees Paid:		_______________	Cash	Check #	_______________