2011 Andover Sno Dragons
Snowmobile Safety Training Registration FormAndover SnoDragons C/O: Tim Holm 2200 Lois Drive Moundsview, MN 55112
Name of Parent or Guardian: _______________________________________________
Address: ______________________________________________________________
City: _________________________________________ Zip: ____________________
Phone (evening): ________________________________________
Email Address: _________________________________________
Student's Legal Name and Birth date:
1. _______________ ________________ _______________ ________ M/F
Last Name First Name Middle Name Birth date Gender
2. _______________ ________________ _______________ ________ M/F
Last Name First Name Middle Name Birth date Gender
3. _______________ ________________ _______________ ________ M/F
Last Name First Name Middle Name Birth date Gender
Class Dates (number choices in order of preference):
_______ October 3rd registration and October 15th 8-2 PM instruction, written test, and also the driving test will be completed.
*Class size limited to 50 students.
Classes held at Oakview Middle School in Andover
Payment is made to the MN DNR on their website.
Registration Selections:
If already a member of the Minnesota United Snowmobilers Association,
please enter member number:_______________ To join MnUSA:
($20.00 per household)_______________ To join Andover SnoDragons:
($10.00 per household, in addition to $20 for MnUSA, $30.00 Total)_______________ Total
Enclosed:_______________
Please mail this completed form, with your check or money order to:
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