Name____________________________________________________

Address__________________________________________________

City_____________________________ State______ Zip___________

Email Address_____________________________________________

Home Phone_________________  Cell Phone____________________

Spouse's Name____________________________________________

AMYA Member ? Yes__ No__   AMYA Member #____________________

Class of boats owned________________________________________

_______________________________________________________

  First Time Members_$30.00   Pd_(__)    Covers first two years dues

  Fees received by___________

In consideration of accepting my membership, I hereby for myself, my heirs, executors and administrators waive and

release any and all rights to claim damages that I may have or acquire against the South Daytona Model Yacht Club(s),

its members, the sailing site owners, employees, agents, representatives, or assigns from any claim for injury or other

damages to me or my family during any and all club events.

Date_________ Applicant's Signature___________________________________

( Try using "Print Page" in the footer )