AMA Membership Application for 1997

Application for 1997 Membership - One applicant per application.

AMA, 5151 East Memorial Dr, Muncie, IN 47302-9252, (317)287-1256, Membership Fax (317)741-0057

Date of Birth: ___________________

Main Interests: (Check one only) _____Indoor ____CL ____RC ____Scale ____FF ____All

All membership categories receive full membership and competition privileges, liability and accident/medical insurance.

For those 19 or over by July 1, 1997 (Check one only!)

___Open Membership - $48.00, Model Aviation Magazine included.
___Extra Family Membership - $30.00 This category applies to anyone who currently resides at the same household as a current open member. Magazine not included.

_____________________________________________________
Current Open member's name and AMA number

For those not 19 by July 1, 1997

Date of Birth: ___________________

___Youth Membership - $15.00, Model Aviation Magazine included.
___Youth: No Magazine - $7.00 (In order to qualify applicant must have same last name and address as current open member) Magazine not included.

_____________________________________________________
Current Open member's name and AMA number

Note: For competition purposes, Youth will be categorized as Junior (under 15 by July 1) or Senior (those 15 by July 1, but not 19).

For those 65 or over by July 1, 1997

___Special Senior Citizen Rate - $38.00 (must submit proof of age at time of original application. Model Aviation Magazine included.

Options:

___Non-US Address add $20.00 for postage.
___Add $6.00 for mailing magazine in envelope.
___Check here for information on non-US membership.

Print clearly in CAPITAL LETTERS

First Name _________________________ Initial ____ Last Name______________________________

Mailing Address Number and Street _____________________________________________________________

City __________________________ State _____ Zip Code _________________

Check enclosed $__________ Charge my ___VISA ____MasterCard $__________

Card Number ____________ - ____________ - ____________ - ____________

Expiration Date ____ / ____

___New Member ___Renewal: give old number if known: _____________________

EVERYONE MUST READ AND SIGN BELOW Please read and sign this declaration. Applications without a signature will be returned.

Note: This waiver means that if I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this waiver does not affect my liability insurance coverage.

Safety Code compliance and waiver and release of liability statement.

"I agree to comply with the AMA Safety Code for all applicable model operations. I understand that my failure to comply with the safety code will result in failure of liability coverage for any damages or claims so caused. I further understand that written notice must be provided within sixty days of the occurrence of any incident.

"I am aware that modeling may present hazards to participants and spectators. I exempt, waive, and relieve the Academy of Model Aeronautics, Incorporated (AMA) from all current or future liability for personal injury, property damage, or wrongful death caused by negligence."

This waiver shall be in force at all times I am a member of the AMA, and the waiver does not require my resignature when I renew my membership.

________________________________
Signature of applicant

_________________________________________
Parent or Guardian of applicant under age 18 must also sign form.

Return to SAM Home Page

Re-Use by Modeling-related Web sites Authorized so long as credit to Society of Antique Modelers appears on page where used. All other rights reserved, including publication. Society of Antique Modelers Chapters (SAM) may re-use images and text from this site so long as credit is published with the image or text and image used: "Used by permission of the Society of Antique Modelers". Members of the Academy of Model Aeronautics chapters (AMA) are granted similiar reprint rights. All other organizations may EMAIL the webmaster for permission to reuse material contained or used on this site.