East Montpelier Gully Jumpers -- VAST TMA and Club Membership Application

VAST TMA and Club Membership Application
East Montpelier Gully Jumpers
P.O. Box 75
East Montpelier, VT 05651
www.gullyjumpers.com

------------PLEASE READ CAREFUL------------

Please follow all instructions carefully, especially the information pertaining to the snowmobile. This information is required and if missing or incomplete the application will be returned. Individuals are reminded that they must have a TMA and Club card on their person to legally operate the snowmobile. If applying by mail, any photocopy's required (snowmobile registration) must be included. Make extra copies of this form for additional snowmobiles.
RESIDENT TMA

A Vermont resident whose snowmobile is registered in Vermont. Attach a photocopy of your registration.
A non-resident who owns property in Vermont and whose snowmobile is also registered in Vermont. Attach a photocopy of your Vermont registration and your Vermont town tax bill.

NON-RESIDENT TMA

All non-residents that do not own property in Vermont.
Vermont residents whose snowmobiles are not registered in Vermont.
Non-resident Vermont property owner whose snowmobile is not registered in Vermont.

------------PLEASE PRINT/TYPE CLEARLY------------

Year	Manufacturer	Model

Reg. Number	State/Province	Country	Snowmobile Serial Number

First Name (Registered Owner)	Middle Initial	Last Name

First Name (Club Member)	Middle Initial	Last Name

PO Box or House Number and Full Street Address, etc.

City/Town	State	Zip Code	+4

Telephone	Email	Age

Vast Savings Plans Pick The TMA that best serves your needs
	Resident		Non-Resident
TMA	Before Dec.15	After Dec. 15	Before Dec.15	After Dec. 15
Regular Snowmobile New to 14 years old	$65 ea.	$90 ea.	$95 ea.	$130 ea.
Family Rate** First two snowmobiles Any additional snowmobiles	$65 ea. $33 ea.	$90 ea. $45 ea.	$95 ea. $48 ea.	$130 ea. $65 ea.
5-Day Pass No Liability Insurance included	$55 ea.	$55 ea.	$55 ea.	$55 ea.
Antique Snowmobile 25 years and older	One time Fee $100 (requires registration)		One time Fee $100 (requires registration)
Classic Snowmobile 15 years and older	$50 ea.	$70 ea.	$50 ea.	$70 ea.
**After the purchase of 2 Regularly Priced TMA's. All sleds NEED to be registered to the SAME OWNER.
See VAST site for details on classifications

PLEASE SELECT MEMBERSHIP TYPE

Vermont Resident

Non-Resident -- Vermont Property Owner

Non-Resident

Regular Snowmobile	$
Family Rate	$
5-Day Pass	$
Pass Dates	From:
(mm/dd/yyyy)	To:
Antique Snowmobile	$
Classic Snowmobile	$
Club Membership - $12.00	$
County Dues - $3.00	$
Grooming Donation	$
TMA Replacement - $5.00	$
Replaces TMA Number:

Total	$