2022 Membership Application & Letter of Intent – New England Trials Association

Rider

First Name *

Last Name *

Age *

On January 1st, 2022

Email *

Phone *

AMA Number *

Expiration *

Emergency Contact *

First

Last

Emergency Phone *

Mailing Address

Street *

City *

State *

Zip Code *

Class

Non-Competition

Check box to not be awarded points towards year-end standings.

Consent / Waiver of Liability

Signature indicates I have read, understand, and agree to this waiver of liability. I agree to hold blameless the NETA, its Board of Directors, members, event organizers/workers, and/or property owners, for any and all damages to my property and/or injuries (including death) to myself or my child/legal ward while participating in any NETA sanctioned/sponsored event. I assume full responsibility, both legal and monetary, for any and all injuries/damages to any person/property that results from my actions or the actions of my child or legal ward while participating in any NETA sanctioned/sponsored events. I understand that motorcycle events are inherently dangerous and hereby agree to comply with all aspects of the NETA Rulebook with special regard to safety issues.

Signature *

Clear Signature

Payment

Payment *

Annual Renewal (16 and older) – $30.00
Youth Renewal (15 and younger) – $15.00
Family (primary member) – $45.00
Family (other member) – $0.00
New Member – $15.00
Day Pass – $15.00
Competition Class Change – $0.00

Mail Renewal Sticker

Yes – $1.00

Check ‘Yes’ to have the renewal sticker for your AMA card mailed to you.

Number Plate Decal

Check ‘Yes’ to receive a free number plate decal. NETA will provide one decal for each rider and one for each family member as part of your membership. After checking the box the customization section will appear.