MARYLAND MODEL YACHT CLUB
APPLICATION AND WAIVER
ZIP CODE: _____________________ TELEPHONE NUMBER______________________
UP TO DATE AMYA MEMBER (Y/N)---------------------------------- # _____________________
EMAIL ADDRESS _______________________________________________@___________________
BOAT FULL SAIL NUMBERS RADIO FREQ.
EC-12 ____________ ___________
VICTORIA ____________ ___________
ONE METER ____________ ___________
In consideration of accepting this application/liability waiver, I hereby for myself, my heirs, executors and administrators, waive and release any/all rights to claim damages that I may have or acquire against the sponsor club, or its members, the pond owner, the sailing site owners, employees, agents, representatives, or assigns, and the American Model Yachting Association, or its members, from any claim for injury or other damages to me during Maryland Model Yacht Club’s events from January 01 – December 31 of the year this was signed.
Maryland Model Yacht Club membership: DUES: $??. PAID:___Y/N_______DATE: _________
MMYC Annual Membership fee $20
Make Checks Payable to Cash or Tom Phillips and mail to:
1604 Turney's Court
Crofton, MD 21114
Thanks for supporting YOUR CLUB!!!!!!!