Coosa Valley Flyers
Membership Application

Name____________________________________________________________________________

last

first

middle

Address___________________________________________________________________________

street

city

state

zip

Phone #____________________________ Birthday______________________________

Email Address____________________________________________________________

______I am currently an AMA member. My AMA number is______________

____ I am not a current AMA member.

Club Membership Agreement

1.) I, ____________________________________ affirm that I am member of or have applied for membership in the AMA and will remain a member so long as I participate in this club.

2.) I will abide by all AMA, and Club rules.

I do hereby agree to abide by all AMA, and Club rules and if found to be in violation, will be asked to leave. If ask to leave, I will peacefully depart. I understand that The Coosa Valley Flyers, any club member, or Property Owner are not responsible for injuries to me or to any member of my party while at the Club flying site.

Signature _______________________________________ Date _________________

Amount received with application $__________________________________________

One time landing fee (if applicable) $_________________________________________ 

Amount due upon membership approval $ _____________________________________

Signature of club member ________________________________________________

______________________________ Application approved

__________________________ Application rejected

______________________________________ Signature of membership committee

______________________________________ Date