Tri County ATV Membership Application
PO Box 134 West
Oneonta, NY 13861
The Tri County ATV Association Is A Family Oriented Group Of ATV Enthusiasts Who Believe In Promoting ATV Safety, Education, Conservation, And having fun! Membership Year from April 1st to April 1st.The Cost Of A Yearly Membership is $35.00 for individuals. This Includes A Tri County ATV Membership w/Decal, NYSORVA Membership, OHVPG Membership And A Quarterly Newsletter. You Must Be 18 Years Or Older To Join .You Must Own Your Own ATV And Have It Insured and Registered To Join The Club, Or Be Sponsored By A Current Active Member Who Allows You Use Of An ATV And That ATV Be Compliant With New York State Laws Regarding Registration and Insurance. Note It Is The Responsibility Of ATV Owner Being A Sponsor To Contact His / Her Insurance Agent To Prove The Sponsored Member Is Covered.
Club Officers
President: Mike Pagillo Jr. Phone: 607-538-1967 Email:mpagillo@hughes.net
Vice Pres: Steve Weygand Phone: 607-432-5039 Email: sweygand@stny.rr.com
Secretary: Dave Bryant Phone: 607-547-8461 Email: bryantde@telenet.net
Treasurer: Steve Zukaitis Phone 607- 829-8304 Email: zukaitis@frontier.net
Mail to: Tri County ATV Association Inc
PO Box 134 West Oneonta, NY 13861
Membership Type:( ) Individual $35.00 ( ) Sponsored $35.00 ( ) Associate $15.00
Applicants Name: ___________________________________
Applicants Address: ___________________________________
Phone #: DOB: Email Address:
Sponsoring / Members Signature: _____________________________________________
Fill Out The Required Insurance Information.
If You Have More Than Two (2) Wheelers Registered To Your Household, Please List Them On Separate Sheet And Attach It To This Application.
Insurance Carrier: _____________________________________________
Policy number: ___________________Plate number: __________________
Insurance Carrier: ______________________________________________
Policy number: ___________________Plate number: __________________
Please Attach Copies Of Registration & Insurance Card For Each Wheeler When Submitting
Those With Out An E-Mail Address Will Receive The Newsletter By Regular Mail
In God We Trust 