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January 6, 2009

2004 Application for Membership

Name     _______________________________________________________________________

Address  _______________________________________________________________________

         _______________________________________________________________________

Phone    _______________________________________________________________________

E-Mail   _______________________________________________________________________
         Allow on Fairmont Fliers Public Web Site ( YES / NO )

Web Site _______________________________________________________________________

AMA #(required)  _______________________________________________________________

How long have you been flying models?  _________________________________________

How did you hear about our club?       _________________________________________

         _______________________________________________________________________

I will not hold the Property Owner responsible for any accidents that may occur.

I will abide by "ALL" club rules and safety regulations as stated by AMA and also the club safety committee.

After the 4th Warning for a disciplinary action, my fellow club members can have me voted out of the club in which I will turn in my key and bow out graciously without fuss.

Signature  _____________________________________________________________________

Date       _____________________________________________________________________


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