Member Sign Up Form


Mudskippers Membership Form

Name(s): _________________________________________________
Address: _________________________________________________
Phone: _________________
Type of Membership (Circle one): Individual ($20) / Family ($30)
T-shirt size: _______(one per membership, not per member)
Emergency contact: __________________________
Name: _______________________________________ Phone #:_________________

Release of Liability

The White Mountain Mudskippers is proud to sponsor rides and events throughout the year. However, The White Mountain Mudskippers and those people associated with the club assume no responsibility for you or your equipment. Your participation in all club related activities is at your own risk. The White Mountain Mudskippers and those associated with the club will not be held liable or responsible in any way for injury or damage to property. Anyone participating in club activities under age 18 must have parental consent, under 16 must have parental supervision.


I have read and understand the above information. (all members listed above must sign)

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