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WYOMING MOTORCYCLE TRIALS ASSOCIATION
2011 MEMBERSHIP APPLICATION

Name(s)______________________________________________

Address_____________________________________________

City________________ State_______ Zip_______

e-mail address_______________________

Home Phone(___)___________

AMA Membership Information:

Name______________________Number__________Exp______
Name______________________Number__________Exp______
Name______________________Number__________Exp______

Check
One		WMTA *Annual Membership Levels
membership descriptions here		Cost
 Season Flyers Only$5.00
 Single Membership$20.00
 Family Membership$25.00
Season Pass = All Events & Single Membership
 Season Pass Membership$175.00

* All memberships expire at the end of each calendar year

Mail with Remittance to:

WMTA
3688 Ridgecrest Dr
Casper, WY 82604