MICHIGAN TEAM-1                                           

MEMBERSHIP APPLICATION                                                                       

 

Mail this form to:          Team-1 Membership

c/o Robert Schultz

5402 Red Fox Drive

Brighton, MI  48114

 

Dues are $20 per year, make checks payable to:  Michigan Team-1

 

                             New              Renewal                    

Please print:

Name:                                                                                        TRA #                

  (first middle last)

 

Address:                                                                                                              

City:                                                  State:                             Zip:                      

Phone:  (home)                                                     (cell)                     _____

Date of Birth:                                   

                       (mm/dd/yy)

 

Email Address:                                                                                                   

Certified:    Yes   No (circle one)                          Authority:   TRA   NAR (circle one)

Level:              Date:                            Location:                                       

Other Rocket Groups:                                                                      

I am applying for TRIPOLI Prefecture 9, (Michigan Team-1) membership status.  I agree to all regulations, safety codes, rules and I am a member in good standing with the TRIPOLI ROCKETRY ASSOCIATION, INC.  It is further understood that by my signature the purpose and objectives of our group is scientific and recreational.

 

I also agree to hold harmlessTRIPOLI Prefecture 9, (Michigan TEAM-1) and TRIPOLI ROCKETRY ASSOCIATION, INC. from any liability of group activities.  This will remain in effect until I submit a letter of resignation or my membership is allowed to lapse.

 

Signed:                                                               Date:                                               

                                                                                                                                (mm/dd/yy)

 

Adult/parent name and signature is required for applicants under eighteen years of age.

Adult/parent name (print)                                                                                                                                         (first middle last)

Adult/parent signature                                                                            Date:                      _______

                                                (first middle last)                                                                                                                                                     (mm/dd/yy)