PARK PILOT PROGRAM ENROLLMENT FORM


Please type or print the information clearly in CAPITAL letters. One individual per form. When completed, mail this form with payment to the Academy of Model Aeronautics, 5161 E. Memorial Dr., Muncie, Indiana 47302-9252.


Park Pilot PROGRAM Membership $38 (includes print and digital editions of Park Pilot magazine)


Mr. Mrs. Ms. First Name: ___________________________________________________ Initial: __________


Last Name: ________________________________________________________________________________________ Mailing Address: ____________________________________________________________________________________ _______________________________________________________________________________________________ Phone: (___________) _______________________________________________________________________________ Email: _____________________________________________________________________________________________ Birth Date: (mm/dd/yyyy) __________/__________/__________ PAYMENT OPTIONS: Check enclosed: $________ OR Charge my:


P VISA MasterCard Discover $________


Card Number: ___ ___ ___ ___ – ___ ___ ___ ___ – ___ ___ ___ ___ – ___ ___ ___ ___ Exp. Date: ____ / ____ Cardholder’s Signature: _______________________________________________________________________________


Recruiter Information: If you were recruited to join the AMA by a member, AMA club or hobby shop, please indicate only one and list the name and AMA number so we can thank them.


Member Club


Name ____________________________________________ AMA # ____________________________ Name ____________________________________________ Club Charter # ______________________ Hobby Shop Name ____________________________________________ AMA # ____________________________


PARK FLYER SAFE OPERATING RECOMMENDATIONS • Inspect your model before every flight to make certain it is airworthy.


• Be aware of any other radio frequency users who may present an interference problem.


• Be courteous and respectful of other users of your selected flight area.


• Choose an area clear of obstacles and large enough to safely accommodate your flying activity.


• Make certain this area is clear of friends and spectators prior to launching your aircraft.


• Be aware of other activities in the vicinity of your flight path that could cause potential conflict.


• Carefully plan your flight path prior to launch.


• Abide by any and all established AMA National Model Aircraft Safety Code items where applicable and appropriate.


PARK FLYER DEFINITION Park Flyer models will weigh 2 pounds or less and be incapable of reaching speeds greater than 60 mph. They must be electric or rubber powered, or of any similar quiet means of propulsion. Models should be remotely controlled or flown with a control line, remain within the pilot’s line of sight at all times, and always be safely flown by the operator. A Park Flyer site can be either an outdoor or an indoor venue. When flying at sites specifically designed for Park Flyers, the pilot will keep the model within the established flight boundaries of the field. Members need to take into consideration several factors including piloting ability, weight, size, and speed of the Park Flyer model to determine if a Park Flyer site is an appropriate venue for flying a particular model. The test should be, “Can I fly this model safely and quietly at this flying site?”


Please read and sign this declaration. Forms without signatures will be returned. Note: This waiver means that if I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this waiver does not affect my liability insurance coverage.


“I agree to comply with the AMA Park Flyer Safe Operating Recommendations for all applicable model operations. I understand that my failure to comply may endanger my liability coverage for any damages or claims so caused. I further understand that written notice of the occurrence of any incident must be immediately provided.”


“I am aware that modeling may present hazards to participants and spectators. I exempt, waive, and relieve the Academy of Model Aeronautics, Incorporated (AMA) from all current or future liability for personal injury, property damage, or wrongful death caused by negligence.”


Signature of Enrollee _______________________________________________________________________________________________


Insurance coverage is effective on the date of receipt at AMA Headquarters of a properly completed enrollment form and correct dues payment. All membership benefits begin on the day a properly completed form and correct dues payment are received at AMA Headquarters. If a magazine is included with the membership, it begins with the first issue available after a correct current form and payment are received. Membership rates and insurance limits are those in effect at the time of printing. Actual cost of dues and amount of insurance coverage is subject to change. Any such change will be noted at the time of membership processing so they may be accepted or not.


Email has provided the AMA with the opportunity to get information to our members in a timely cost-efficient manner. The AMA occasionally partners with reputable firms to promote products that will benefit both the member and the association. The AMA does not trade or sell email or mailing addresses. If you would prefer that we not include your name, please check the box(es) below.


Please do not use my email address for anything other than official AMA business. Please do not use my mailing address for anything other than official AMA business. THEPARKPILOT.ORG 55


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