South Daytona R/C Model Yacht Club

AMYA Sanctioned Club # 163

 

 

APPLICATION FOR MEMBERSHIP

 

 

Date___________________                                      Frequency Assigned____________

 

 

NAME­­­­­­­­­­­­­­_________________________________________________________________

 

ADDRESS______________________________________________________________

 

CITY___________________________________STATE__________ZIP____________

 

PHONE________________________SPOUSE’S NAME________________________

 

OTHER ADDRESS______________________________________________________

 

EMAIL ADDRESS_______________________________________________________

 

AMYA MEMBER?     YES   NO      AMYA  MEMBER  #______________________

 

CLASS OF BOATS OWNED______________________________________________

 

________________________________________________________________________

 

INITIATION FEE__________________ ANNUAL DUES_______________________

 

FEE RECEIVED BY_____________________________________________________

 

In consideration of accepting membership, I hereby for myself, my heirs, executors and administrators, waive and release any and all rights to claim damages that I may have or acquire against the club(s) or its members, the sailing site owners, employees, agents, representatives, or assigns, and the South Daytona R/C Model  Yacht Club or its members, from any claim for injury or other damages to me or my family during any and all club events.

 

Date___________ APPLICANT’S SIGNATURE______________________________

 

 

Please print out and complete. Bring to pond to submit on any Saturday