2001 Membership Application
Academy of Model Aeronautics 5151 E. Memorial Dr. Muncie, IN 47302 1-800-435-9262
Only one applicant per form. You may photocopy if needed.
Membership type
- New member
- Renewal: give old number if known ____________________
Name and address
- First Name ___________________ Initial ____ Last Name ___________________
- Mailing Address (number and street) _______________________________________
- City ____________________________ State ________ Zip Code _______________
You may send this application by fax if paying by VISA or MasterCard. Fax Number: 1-765-741-0057
- Yes, please send a confirmation to: Fax number: (_____) ___-_____
- Home phone number: (_____) ___-____ E-mail Address _______________________________
- Work phone number: (_____) ___-____
All membership categories receive full membership and competition privileges, liability and accident/medical insurance.
- Date of Birth (requested for all applicants) _________________________________
Membership fees and categories
For those 19 or over as of July 1, 2001:
- Open Membership - $48.00 (Model Aviation included)
- Extra Family Membership - $30.00 (This category applies to any one adult who currently resides at the same address as a current Open Member; magazine not included.)
- Current Open member's name and AMA number ___________________________________
For those 65 or over as of July 1, 2001:
- Senior Citizen Membership - $38.00 (Must submit proof of age at time of original application). Model Aviation included.
Options: Museum Patron Programs
- Museum Patron $25.00
- FAI Stamp $35.00
- Supporting $100.00
- National Site Development $_____________
- Sustaining $500.00
- Add $6.00 for Model Aviation mailed in an envelope
- Life $1,000.00
- Total $ ____________
- Payment method: Check o VISA o MasterCard
- Credit Card No. ____-____-____-____ Exp. Date ___ / ___
- Card Holder's Signature _________________________________
Interests and participation
Primary Interests: (check one)
- Control Line
- Free Flight
- Radio Control
- Rocketry
- Aerobatic
- Racing
- Indoor
- Electric
- Pylon
- Jets
- Combat
- Scale
- Outdoor
- Helicopter
- Soaring
Area of participation: (check one)
- Speed
- Carrier
- Pattern
- Scale
- Sport
Safety Code compliance and waiver and release of liability statement
Everyone MUST read and sign below - Applications without signatures 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.
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 immediately after 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 AMA, and the waiver does not require my re-signature when I renew my membership.
Signature _________________________________ Date ___________________
For HQ use only
Transcribed from original scans by AI. Minor OCR errors may remain.
