MMYC Application & Waiver Form

MARYLAND MODEL YACHT CLUB

APPLICATION AND WAIVER

 

NAME:             ____________________________________________________________-___

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.

 

Signature:___________________________________Date:____________________________

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!!!!!!!

 

 

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