Mr. Mrs. Ms.
Mailing Address (number and street) Apt. #
City State Zip Code
Home tel. ( ) Work tel. ( ) FAX ( )
E-mail Date of Birth (Required)
E-mail has provided AMA with the opportunity to get information to our members in a timely cost-effective manner. AMA on occasion partners with reputable firms
to promote products that will benefit both the member and the association. AMA does not trade or sell e-mail or mailing addresses.
Do not use my e-mail address for anything other than official AMA business Do not use my mailing address for anything other than official AMA business.
MEMBERSHIP CATEGORIES All membership categories receive full membership, liability and accident/medical insurance, and competitive privileges
OPEN Adult Memberships - For those 19 or over as of July 1, 2013
OPEN Membership $58.00 Model Aviation included.
NEW OPEN Members – New AMA members joining during these periods will receive a prorated membership price.
April 1st through June 30th $43.50 July 1st through September 14th $29.00
OPEN Senior Membership $48.00 Model Aviation included. (For those 65 or over by July 1, 2013).
NEW OPEN Senior Members – New AMA members joining during these periods will receive a prorated membership price.
April 1st through June 30th $36.00 July 1st through September 14th $24.00
EXTRA Family Membership $30.00 Model Aviation not included. (Applies to any one adult who resides in the same household as a current OPEN member.)
List current OPEN member’s name and AMA number. Name AMA#
PARK PILOT PROGRAM* $29.95 Park Pilot magazine included. **Aircraft must not exceed 2 pounds, 60 mph, and may not be powered with an internal
combustion engine. Does not have voting rights, cannot compete in competitions, and has reduced liability insurance and no fire, theft, or accident/medical
Park Pilot members can subscribe to Model Aviation magazine - $36.00
Free Youth Memberships - For those under 19 as of July 1, 2013
Note: For competition purposes, YOUTH will be categorized as Junior (under 15 by July 1) or Senior (Those 15 by July 1 but not 19)
FREE YOUTH Membership Add Model Aviation magazine subscription. One-year $15.00 Add Park Pilot magazine subscription. One-year $9.95
Add Model Aviation and Park Pilot magazine subscription. One-year $19.95
For Non-U.S. Permanent Residents
AFFILIATE MEMBERSHIP $28.00 insurance only while flying in the USA. Model Aviation not included. Membership in National Aero Club (NAC) is
required. Please provide copy of NAC membership card/record.
Name of National Aero Club Expiration Date
AFFILIATE MAGAZINE SUBSCRIPTION add $60.00 for a total of $88.00.
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) so we can thank them.
Member/Club/Hobby Shop – Name AMA#
Support AMA Programs
Scholarship Fund National Site Development Disaster Relief Fund Government Relations Museum Patron Program Membership
$25 $25 $25 $25 $25/Patron
$50 $50 $50 $50 $50/Supporting
$100 $100 $100 $100 $100/Sustaining
Other ____ Other ____ Other ____ Other ____ $1000/Life
If you haven’t, please consider naming AMA in your will.
Add $4.00 for Model Aviation mailed in a protective covering
Area of Interest: Please select one area of interest. METHOD OF PAYMENT
RADIO CONTROL VISA MasterCard Check enclosed Amount $
FREE FLIGHT Card No. - - - Exp. Date /__ __
I compete in FAI activities Signature _____________________________________
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
“I agree to comply with the AMA Safety Code for all applicable model operations. I understand that my failure to comply with the Safety Code 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
Parent or Guardian of Enrollee under age 18 must also sign
Membership ends each year on December 31, regardless of the date a membership form is received. All membership benefits begin on the day of receipt at AMA Headquarters of a properly completed form and correct
dues payment. If a magazine is included with the membership, it begins with the first issue available for the year after a correct current form and payment are received; it expires with the issue printed in December (which is
dated January of the following year). 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 changes will be
noted at the time of membership processing so they may be accepted or not. Forms received after September 15 will be valid for the remainder of that year and all of the following year.
149 Model Aviation AUGUS T 2013 www.ModelAviation.com
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AMA Membership Enrollment Form
ACADEMY OF MODEL AERONAUTICS
Enrollment form for 2013 Membership – ONLY ONE FORM PER INDIVIDUAL
5161 E. Memorial Dr., Muncie, Indiana 47302-9050, Fax: (765)741-0057, www.modelaircraft.org
New Membership Renewing Member (provide AMA number if known)
Initial Last Name