DVSJ TMA RENEWAL 2017/2018 Form

DVSJ TMA Renewal – 2017/2018

Name of Registered Owner:

First:_____________________ Middle Initial:__________ Last:______________________________________

Mailing Address: (number & street)


City:___________________________________________State:___________ Zip Code:____________________

Physical Address (if different from mailing above)

Mailing Address: (number &street)


City:___________________________________________State:___________ Zip Code:____________________

Telephone Number(s): ____________________________

E-Mail: _______________________________________

Rider or Club Member Information: (one per Registered Snowmobile)

Full Name:_______________________________    Year Born:

Full Name:_______________________________    (After July 1, 1983: must have Vermont Safety Certificate)

Full Name:_______________________________

Full Name:_______________________________    (Additional members above the number of registered

Full Name:_______________________________    snowmobiles for an additional fee of $20.00)

Snowmobile Information

Year                 Manufacturer                          Serial Number            Registration Number                    State








TMA Fee(s)
# of Vermont Registered Snowmobiles – _________at $_____________each = $________________
# of Vermont Registered Family Snowmobiles – _________at $_________each = $________________

Club Dues
Total Snowmobiles: ______@ $25 each = __________

Total additional Members:______@ $25 each=___________

Donation to Supplement Grooming Fund $_______________

Total Enclosed $ _________________________

HOLD FOR PICKUP AT Southern Vermont Deerfield Valley Chamber of Commerce, Main Street Wilmington **PREFERRED**______________

or RETURN via Postal Service___________________________

                    In order to protect landowners who make their land available for recreational use by members of the public, the State of Vermont has passed legislation limiting the liability of those landowners to members of the public who use the land for recreational purposes. This includes the use of property for snowmobiling. Because a landowner has made land available without consideration for recreation purposes, there is no assurance that the land is safe for recreational uses, nor does it create any duty on a landowner of land to inspect the land to discover dangerous conditions. Thus you as a member of VAST when using any of the trails which constitute the Statewide Snowmobile Trail System (SSTS) use these trails knowing that you have no assurance that the trails are safe or have been inspected. You must take care to use them with caution for yourself and due regard for your safety and that of others using the Trails.. You are deemed to have assumed all of the risks attendant, the land on which the SSTS is laid out and all of the risks inherent in snowmobiling. As a member of a VAST snowmobile club, I the undersigned, owner of the snowmobile(s) described above, declare that I am liable for the use of a VAST trail as part of the SSTS in conformance with the snowmobile laws and rules of the State of Vermont.

                    Without limiting the generality of the foregoing, I declare that I am well aware and accept that snowmobiling is an inherently risky activity. As an off road experience trail conditions may change without warning and trail signing is not a legal requirement. When signage is provided it is used for directional purposes only. I assume all risk of personal injury, death or property loss resulting from any cause whatsoever, including, but not limited to the risks, dangers and hazards of snowmobiling. VAST shall not be liable for any such personal injury, death or property loss and I waive all claims with respect thereto. I also waive, release and forever discharge VAST and any of its directors, officers, agents, servants and successors from any and all claims for loss, damages, costs, contributions, indemnification or any other instance whatsoever on account of or in any way growing out of all personal injuries, death or property damage of any nature arising out of the use of the SSTS unless the same is the result of willful or wanton misconduct. I also pledge that I will inform any person to whom I would lend for rent the snowmobile that I own of the risks mentioned above and will advise them that VAST, club or the landowner of the trail does not assume any responsibility for the damage they could undergo while using a VAST trail.

_______________________________________________              __________________
Signature                                                                                             Date