Jackson Model Rocketry Club Application
 

Date _________________

Name _____________________________________________________

Date of Birth ____________________ , ___________

Address ___________________________________________________

City _______________________ State _______ Zip Code ___________

Phone Number (home) (_____)______________________

*Optional #’s* (work) (______)_______________ (cell) (______)______________

Email address ________________________________________________________

Do you belong to NAR? _________ TRA? _________

If yes, what is your number NAR# _______________ TRA# _________________

If applicable, Certification Level _______

What range of motor classification do you normally launch? ______________

(e.g. A – H)  (there is a separate launch fee for high powered rockets or engine sizes E and above)

Would you be willing to help out during a launch (set-up, LOC, etc)? ____________

I pledge to conduct all my rocketry activities in compliance with JMRC, NAR and

TRA safety codes in addition to all local and state laws. I understand that willful

violation of the safety code(s) is cause for rescission of membership and dismissal from the club.

Signature (required) _____________________________________________________

Membership fees are $30.00 a year for 18+ years of age

Membership fees are $10.00 a year for 17 and younger

Make checks payable to: Jackson Model Rocketry Club

Mail completed application with payment to:

Jackson Model Rocketry Club

4788 Moon Lake Rd.

Jackson, MI 49201