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LAKELAND AERO MODEL CLUB, INC.

A FIXED WING AIRCRAFT CLUB


RENEWAL AND NEW MEMBERSHIP APPLICATION FORM
Date:
Name:
Street address:

ATTACH

City:

State:

Zip:

COPY OF

Phone: (home)

A.M.A. CARD

(business)

HERE.
DONT

email address:
Date of birth: (Month)

(Day)

(Year)

FORGET

A.M.A. membership number:


Years in Radio Control Hobby:

THANKS
Special interest areas:

Flying ability rating: (check one) Beginner

Student

Novice

Pilot

Instructor

Other R.C. Club affiliations:

Membership Categories and Dues: (please check one) * Refer to instruction sheet for more information on dues.
Open-Age 18 through 85 as of January 1st this year...$25.00
Bergen County flying field permit-new members..$25.00
Student-Any full time academic student $15.00
Junior-Less than 18 years old as of January 1st this year$15.00
An application for a junior must be signed by a parent or legal guardian.
A junior member must be accompanied by a responsible adult while at the field.
Parent/legal guardian signature:
I the undersigned-understand and will abide by both the AMA and Lakeland Aero Club Inc. field safety and flying rules for all model aircraft and operations at the
Lakeland Aero Club field. I further agree to abide by and comply with the Lakeland Aero Club bylaws and standing rules and to any changes or modifications that may
be made to them during my membership period. I understand and agree that as conditions of membership my failure to comply with all the applicable safety and flying
rules and or failure to conduct myself in a gentlemanly/lady like manner will result in their revoking of my membership. I understand and agree to provide the AMA
and Lakeland Aero Club OFFICER written notice within thirty (30) days of an incident of bodily injury and or property damage, I am very aware that aircraft
operations present hazards, and I exempt and hold harmless to Lakeland Aero Club its officers and members from all liability including personal injury, property
damage, or death caused by myself or my guests actions. I further understand that violation of same can be cause for disciplinary action in the form of a letter of
reprimand (1st offence)-suspension of flying privileges (2nd offence) and possible dismissal from the club for extreme repeat offences.

MEMBERS SIGNATURE

CLUB USE ONLY:


Date of club acceptance:

Sponsor:

Executive Officer or Membership chairman signature:


INSTRUCTIONS:
1. Make checks (no cash) payable to: LAKELAND AERO MODEL CLUB, INC.
2. Make sure application has check & copy of your A.M.A. card.
3. Application may be submitted at a club meeting or mailed.
4. Prospective new member must be in attendance at two meetings prior to acceptance work related
exemption is available upon prior notice.
5. New members only shall pay the Bergen County flying field permit fee as noted above.
6. All new members will be viewed as a provisional pilot and must be certified as to flying abilitybeginner and expert alike.
7. Send application to: LAKELAND MEMBERSHIP c/o
Raymond Boos
13-01 Plaza Road
Fair Lawn, New Jersey 07410
201-791-0813

Lakeland is designated a fixed wing model aircraft club but welcome those members those preference is for
rotary wing aircraft .The fixed wing membership generally fly during the morning period of the day from 9:00
am through 2:00 pm but does not restrict rotary wing aircraft. It will be up to the membership in attendance at
the field to set a schedule of flying time for both the fixed and rotary wing aircraft. We do encourage that group
flying of the rotary wing membership be scheduled after the fixed wing flying. Late afternoon flying will be
considered open and again it is up to the attending membership at the field at the time to set a fair and equitable
schedule of flying. This basically follows the scheduled flying time of the individual member when a large
group of pilots are present be they fixed or rotary wing.

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