MANSFIELD NORDIC CLUB

MASTERS DIVISION

www.geocities.com/mansfieldnordicclub

Name:________________________________________________

Address:____________________________________

____________________________________________

____________________________________________

Phone:___________________________________

EMAIL:___________________________________

____________ NENSA MEMBER (must be member)

____________ EABC MEMBER (must be a member)

PRIMARY INTEREST?

RACING___________FITNESS___________OTHER____________

2008/2009 Season CLUB FEE:

__________ $100 Coaching & Club Membership

__________ $50 Training only and Club Membership (no coaching)

Make checks payable to MANSFIELD NORDIC CLUB

Send to :

Timothy Reny

PO Box 106

Underhill Center, VT 05490