Membership Application

 RECKER R/C CLUB, INC. APPLICATION

Name:  _________________________________
Date of Birth: _______/_______/_______
Phone:  _______ - _______ -  _________
Address:  _________________________________
City:  ____________________________________
State:  _________,   Zip Code:  _______________
Email Address:  ___________________________
AMA Number:  ___________________________
FAA Number: ____________________________

Please Check Level Of Interest:
______ I need help with selection of plane/equipment
______  I am new to the hobby and need help  building and/or learning to fly.
______ I know how to fly, but sometimes need help
______ I know how to fly. 

Yes, I want to become a member of the Recker R/C Club
and I understand that the annual dues are $125.

Please contact Secretary - Treasure Jerry McNutt for any questions concerning dues and amounts.

 I am enclosing my check or cash payment.
My signature indicates that I agree to abide by and adhere to the AMA safety code and the Recker R/C Club field and flying rules and that any violation thereof may result in the imposition of the sanction including the loss of privileges and membership.

 I understand I am responsible for any damage caused to other members, guest, or the general public as a result of any negligence on my part.

Signature:________________________________________

 Return this form with a copy of your current AMA card and FAA number to:
Recker R/C Club, Inc.
Jerry McNutt (Sec.-Treasurer)
201 East Perry Street
Walbridge, Ohio 43465
Phone: 419-661-9167       Email: p51nutt4@aol.com