Edition: Model Aviation - 2017/09
Page Numbers: 129

Enrollment Form for Membership

Questions? For help completing this form, contact AMA at (800) 435-9262. www.modelaircraft.org

Return completed form to Academy of Model Aeronautics, 5161 E. Memorial Dr., Muncie IN 47302. Or fax your form to: (765) 741-0057.

1. Contact Information

(Only one individual per form.)

Mr.   Mrs.   Ms.   First Name & Initial   Last Name

Mailing Address (number and street)   Apt.#

City   State   Zip Code   Phone

Date of Birth:   Email:   New Member   Renewal   AMA # (Renewals only - leave blank if unknown)

Recruiter Information: If you were recruited to join AMA by a member, AMA club, or hobby shop, please indicate only one and list the name and AMA number (if known).   Recruiter Name:   Recruiter AMA #

Primary area of interest (choose only one): Radio Control   Control Line   Free Flight   Rocketry   Multirotor

2. Membership Category

Choose only one of Adult, Park Pilot, Youth, or Affiliate memberships.
All membership categories receive membership, liability and accident/medical insurance, and competitive privileges unless noted.

Adult Memberships

One-Year Memberships   Two-Year Memberships

Adult (New & Renewing) - For adults 19 or over as of July 1, 2017. Includes subscription to Model Aviation magazine.
Choose Adult $75.00   Choose Adult $140.00

Senior (New & Renewing) - For adults 65 or over as of July 1, 2017. Includes subscription to Model Aviation magazine.
Choose Senior $65.00   Choose Senior $120.00

Extra Family - For any adult who resides in the same household as a current Adult Member. Does not include a subscription to Model Aviation magazine.
Choose Extra Family $38.00   Choose Extra Family $70.00

Current Adult Member’s Name and AMA #

Included Magazine Options
Adult and Senior memberships include a subscription to Model Aviation magazine.
Choose magazine delivery method: Print   Digital   Both ($9.95)   Print   Digital   Both ($19.90)
You may choose to receive your print magazine in a protective plastic wrap. Protective wrap ($4.00)   Protective wrap ($8.00)

Extras
You may add a subscription to Park Pilot magazine, a quarterly publication covering small-field and indoor electric aircraft.
Print (1-Year) $9.95   Print (2-Year) $19.90   Add Free Digital Edition (Print subscription required)
You may subscribe to one or two years of Park Pilot magazine regardless of the length of your Adult membership.
You may choose to receive your print magazine in a protective plastic wrap. Protective wrap (1 Year) $2.00   Protective wrap (2 Years) $4.00

STOP   Adult membership enrollment complete. Go to section #3.

Park Pilot

Park Pilot (New & Renewing) - For adults 19 or over as of July 1, 2017. Includes subscription to Park Pilot magazine.

Park Pilot membership is for aircraft 2 pounds or less that fly below 60 mph and does not include soaring rights or competitive privileges. Park Pilot membership insurance benefits are limited to $500,000 of liability coverage.

Choose Park Pilot $38.00   Choose Park Pilot $70.00
Free Digital Edition. Receive the digital edition of Park Pilot magazine as well as the print edition.

You may choose to receive your magazine in a protective plastic wrap. Protective wrap ($2.00)   Protective wrap ($4.00)

Extras
You may add a subscription to Model Aviation magazine. Model Aviation is the monthly flagship publication of the AMA and offers our most extensive coverage of the hobby.
Print (1-Year) $36.00   Digital (1-Year) $36.00   Both (1-Year) $45.95
Print (2-Year) $72.00   Digital (2-Year) $72.00   Both (2-Year) $91.90
You may subscribe to one or two years of Model Aviation magazine regardless of the length of your Park Pilot membership.
You may choose to receive your print magazine in a protective plastic wrap. Protective wrap (1 Year) $4.00   Protective wrap (2 Years) $8.00

STOP   Park Pilot membership enrollment complete. Go to section #3.

Youth

Free Youth   For children and young adults under 19 as of July 1, 2017. Choose Free Youth (FREE)

Extras
Youth extras: Enjoy the entire hobby with Model Aviation magazine.
Print ($15.00)   Digital ($15.00)   Print & Digital ($19.95)
Receive your magazine in a protective cover wrap. $4.00
Youth extras: Learn about park flying with Park Pilot magazine.
Print ($9.95)   Add Free Digital Edition (Print subscription required)
Receive your magazine in a protective cover wrap. $2.00

STOP   Free Youth membership complete. Go to section #3.

Affiliate

Affiliate
(For non-U.S. permanent residents)
Insurance and competitive privileges only while flying in the USA
Choose Affiliate $36.00   Choose Affiliate $68.00

Extras
You may subscribe to one or two years of the digital edition of Model Aviation magazine regardless of the length of your Affiliate membership.
Digital (1-Year) $36.00   Digital (2-Year) $72.00

STOP   Affiliate membership complete. Go to section #3.

3. Support the AMA Foundation

Scholarship Fund: $25   $50   $100   Other: $____
AMA Site Development: $25   $50   $100   Other: $____
Club Support: $25   $50   $100   Other: $____
General Fund: $25   $50   $100   Other: $____
Museum Patron Program: $75 Patron   $100 Supporting   $1,000 / Life
Donations Total:

4. Payment

Check   Visa   Mastercard   Discover   Card No. ____________________   Exp: ____ / ____

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

If I am involved in any claim or suit I will not sue the AMA, Inc. I understand that this does not affect my liability insurance coverage. “I agree to comply with the AMA Safety Code.”

Signature: ______________________________