Office Use:
CK#:_________
Cash:_________
Processed:_________
NYSSA#: _________
Key id:___________________
2016-2017 Membership Options:
 New Family Membership
 Renew Membership
 Landowner Membership
Registration Information
First Name
Last Name
Address
City
State
Zip Code
Telephone
Move to new location? Old Zip Code
Number of sleds registering
NYSSA Voucher  Online (NYSSA website)
Options
 Mail Voucher
E-Mail
I would like to volunteer  Trail Work  Club Rides  Winter Festival  Other Club Events
Key Card Access – located on bottom right of key card(s) ex. 3015 #### H (please provide all cards)
Key Card Numbers
Family Information – NOTE: Children under 18
Spouse or Partner Name
Child 1 Name
Child 2 Name
Child 3 Name
Child 4 Name
Payment Information
Family Membership: Includes kids under 18, Snowmobile Trail Map, Activities Card, Sled
Stickers, NYSSA Membership, Newsletters, Registration Discount Voucher (Saves $55.00 per sled)
$35.00
Clubhouse Access (Electronic Door Access)
Number of renewal key:
x $5.00 Each
Save the club money RENEW your same card!
Number of new key:
x $5.00 Each
Number of Extra Map:
x $8.00 Each
Extra County Tail Map
Number of Club Stickers:
x $3.00 Each
3”x 6” Club Logo Sticker
Used for Maintenance and Fuel
Groomer Fund Donation
-------SM____ MED____ LG____ XL____ XXL____ x $20.00 Each
Black Shirt with design
All funds from this program goes to groomer repairs!
Trail Sponsor Bonus Program
(Valid 12/01/16 to 04-01-17)
Gold Upgrade
10% Discount Add $50.00
*See below for detail*
Platinum Upgrade
15% Discount Add $100.00
$
Total Amount Enclosed
Restaurants, Resorts and Hotels *Establishments may change at anytime
Chautauqua Restaurant & Lounge (Bellies)
Lakeview Restaurant & Bar
Murdock’s Family Restaurant
Webb’s Captain Table & Lounge
Chautauqua Suites
Lakeview Hotel
Peek’n Peak Resort & Spa
Webb’s Year-Round Resort
Chautauqua Harbor House
Mayville Dinner
Nickle Plate Depot
Fork n’ Barrel
Dealers & Accessories
Leisure Time: Ski-Doo, Polaris,
Honda, Suzuki
Off-Road Express: Yamaha, Arctic
Cat, Ski-Doo, Polaris
Schutts Saw & Mower Service:
Arctic Cat
I agree to abide by all rules and regulations concerning the safe operation of Snowmobiles, Club Policies,
By-Laws, and decisions of Club Officers to the best of my ability. I will perform all duties and obligations of Club Membership.
Signature: _________________________________________________________ Date: _____________
NOTE: Checks payable to “Chautauqua Lake Snowmobile Club” *$50.00 return check fee
Mail Application and check to: “CLSC Membership” P.O. Box 134; Mayville, NY 14757
Questions Call Matthew Terrill – [email protected] – 716-326-6919
June 1, 2016
It’s time to start to think about winter! Yes, we know summer has not even started yet but we have so
much to do to with providing you the BEST snowmobile club we can! We have added another membership
coordinator to our membership team and with that new and improved ways of processing applications,
fulfillment of membership packets and any extras you may have purchased.
This year’s application you have received is semi filled out with the information you supplied us with
last year. If any of the information is incorrect or MISSING please fill in the new information on the form or
make additional notes below. If you have already renewed your membership online here is your chance to
order extra maps, club stickers, order a key for the club house, join the Trail Sponsor Bonus Program, and
donate to the groomer fund.
Once receiving your application and payment, we will work on processing your Club Membership and
New York State Snowmobile Association voucher. We encourage you to print your NYSSA voucher out
yourself from http://www.nysnowmobiler.com saving the club postage and processing or we can mail it to you.
Printing the voucher out in black and white is fine this year. Additional purchases such as key cards, club
stickers, will be mailed out after processing your application. Bonus Card Program will be mailed out in
November for the program to start December 1st. Maps will be sent out when our club receives them in
December.
Sincerely,
Matthew Terrill