MMRCA Membership Application

Year 2019

* required field

Name: *

Address:

State:

Zip:


Cell Phone:

Home Phone:

Work Phone:


E-mail: *


Comment:

Member Status: Renewal New Member

AMA Number:


Radio Freq: If selecting 72MHz please list your channel information in the box provided.
2.4GHz
72MHz
Other


Membership Fee:
Flying Member $85:
NON-Flying Member $85:
Youth Member $55:


Additional Family Members:
There is a $25 membership fee for each additional family member.

Name: AMA Number:

Name: AMA Number:

Name: AMA Number:


MEMBERSHIP AGREEMENT*

I have read and agree to abide by all AMA, Mid-Missouri Radio Control Association, and the City of Columbia Laws, By-Laws, Rules, Flight Guidelines
and Safety Regulations that apply to our field. I also understand that violations of these laws, By-Laws, rules, regulations and/or guidelines can result in loss
of membership as well as other actions as deemed appropriate by the governing authority.

Please check the following box and provide the date you agree to these terms. The membership application will be rejected if you dont check the box
to agree to the "Membership Agreement", provide the date, or the AMA number is NOT VALID for the year applying for membership!

          Agree:           Date: