Office
Use Only Permit # Invoice #
N.B.F.S.C. Trail Permit Application Form
2007-2008 Season
PLEASE CHECK BOX TAX
TOTAL
|
Within
To obtain your permits, please fill out the following information and send the form back to the N.B.F.S.C. along with your money order in CANADIAN FUNDS or fill in the credit card information below.
Name:
Address:
(Street)
______________________________ _________ _________________
(City) (Prov./State) (Postal/Zip
Code)
Phone #: Club # (see map)
From time to time we do disclose personal information to others who
wish to send out promotional information. Please check the appropriate box
below with respect to the receipt of promotional information from third
parties.
__ I do wish to receive information. __ I do not wish to receive information.
VISA / Mastercard # __________________________ Expiry Date : ______
Waiver
of Risks
PLEASE
READ CAREFULLY.
PLEASE INITIAL INDIVIDUAL CONDITIONS.
1.
BY
SIGNING THIS DOCUMENT YOU GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO
SUE. *Init :
2.
Assumption
of Risks and Waiver of Claims: I hereby
assume all responsibility for any injury, death, loss or damage which I or any
passenger on my snowmobile or alternative driver of my snowmobile may
suffer. I agree to waive any and all
claims that I have or may have against the New Brunswick Federation of
Snowmobile Clubs Inc., Member Clubs, Land Owners and their officers, directors,
employees, volunteers, representatives or agents and I hereby release, waive
and forever discharge them from any and all claims, demands, damages, actions
or causes of actions from whatever cause.
*Init :
3.
I
acknowledge having read and understood the above and agree to each term and
agree to inform all other users or passengers of my snowmobile of these
conditions of sale. *Init :
Members Signature : ______________________________________________________
Please complete the following information:
[ ] Please use the registered owner's address on the Application for Trail Permit for the mailing of a subscription Atlantic Snowmobiler Magazine. Name (if different)______________________________________________
Address (if different) _______________________________________________________________________
[ ] Please do not send Atlantic Snowmobiler Magazine. The applicant agrees to the above.
Signature _______________________________________________ Date : ___________________________
Mail To: The
E7M 1Y4
Or Fax : 506-325-2627
If you have any questions please feel free to call us at 506-325-2625.
Thank you for your interest in snowmobiling in