MEMPHIS PROP BUSTERS MEMBERSHIP APPLICATION

First Name______________________ Last Name_____________________________

Address_______________________________________________________________

City____________________________ State______ Zip Code____________________

Home Phone_____________________ Email Address__________________________

Date of Birth____________________

Name (As to appear on your badge)_________________________________________

AMA Membership #__________________

(Please submit a copy of your AMA Card) or Check here if your AMA membership is pending (___)

Skill Level: Novice (__) Intermediate (__ ) Advanced (__ )

Please list all your active channel #’s (23, 41, etc.) _____________________________

I do hereby agree to abide by the rules and regulations of the Memphis Prop Busters, Inc. and the Academy of Model Aeronautics, Inc. including the by-laws of both corporations and all amendments thereto.

Signed _______________________________________ Date ________________

*** Anyone who flies at the Memphis Prop Buster’s field must have a valid AMA membership. All Club and AMA regulations and safety guidelines apply. Memphis Prop Busters or it’s officers are not responsible for injuries, loss, or damages that may occur at the field location or anywhere else.

Dues schedule:

After September 1st the dues are 1/2 the normal price for the remainder of the year

______ Open Membership (18 years of age or older) Annual Dues- $100

______ Senior Membership (65 years of age or older) Annual Dues- $75

______ Junior Membership (under 18 years of age) Annual Dues- $25

______ Family Membership ($100 plus $25 per each additional family member) Max Annual Dues- $150

Make check payable to: Memphis Prop Busters

Mail to the Treasurer:
Dave Pope
3773 Shirlwood Ave.
Memphis, TN 38122

Last updated: January 2008