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2018 RMHPA Membership Form
Email address *
Visiting Pilot?
Local Pilot?
Student (P0, P1)
Lookout Waiver Signed?
First Name
Your answer
Last Name
Your answer
Home Address
Your answer
City
Your answer
State
Your answer
Zip
Your answer
Phone Number
Your answer
USHPA Number
Your answer
USHPA Member Expiration Date
MM
/
DD
/
YYYY
Hang Gliding Rating
Paragliding Rating
Mini Wing Rating
Tandem Rating
Emergency Contact #1 Name
Your answer
Emergency Contact #1 Phone
Your answer
Emergency Contact #2 Name
Your answer
Emergency Contact #2 Phone
Your answer
Payment method you intend to use for your dues. Pay>> http://www.rmhpa.org/join *
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