Flight Club 502 Membership Form
Prerequisite: Intro to Aviation Class and Senior Member Approval
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First Name *
Last Name *
City *
State *
Zip code *
Name of School or College *
Grade *
Date of birth *
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DD
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Member Cell *
Member E-mail *
Gender *
Parent/Guardian Name (if older than 18 can put N/A) *
2nd Parent/Guardian Name
Parent/Guardian Cell (if older than 18 can put N/A) *
2nd Parent/Guardian Cell
Parent/Guardian E-mail (if older than 18 can put N/A) *
2nd Parent/Guardian E-mail
Do you have a pilot in your family?
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If so who?
Have you ever flown in an airplane *
Why are you interested in joining flight club *
Do you have any family, friends, or neighbors involved in flight club *
If so who?
Youth: By signing this agreement you agree to the following: A. Agrees to indemnify and hold harmless the club against any loss, liability or damage to persons or property in excess of the amount of insurance coverage while the member is in control of the aircraft. The member waives any claim that said member, his property, or his person may generate as a result of such losses, liability or damage to persons or property through use of the club plane. B. This agreement shall be construed in accordance with the laws of the state of Kentucky. C. The club reserves the right to increase the cost of membership and/or aircraft hourly cost or dues because of unforeseen circumstances such as inflation, increased insurance rates, etc. D. Any member wishing to terminate his obligation under this agreement, may do so as follows: By forfeiting this agreement in writing. E. If member is not of legal age member and parent signature required. By typing my full name in the box below, I agree that this is my electronic signature and that it is the electronic representation of my hand-written signature and/or initials for all purposes of approving the terms of this document. Electronic Member signature below: *
If under 18, Member Parent signature. By typing my full name in the box below, I agree that this is my electronic signature and that this is the electronic representation of my hand-written signature and/or initials for all purposes of approving the terms of this document:
PHOTO CONSENT: Flight Club 502 requests permission to use your child’s photograph publicly to promote f light camps and flight club. I understand that the images may be used in print publications, online publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use.
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FLIGHT CLUB SENIOR MEMBER RECOMMENDATION Required, Name of Senior Member Sponsor (who taught your intro to aviation class).
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