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 NAME_______________________________________________________________________Street Address______________________________________________________________________
City _________________________________ State___________ Zip code_____________
TELEPHONE:  Main__________________________________Other__________________________________
EMAIL: _________________________________________________________________
FAA RATING(s) / CERTIFICATE #(s) _____________________________________________________________________________DOB______________
SSA MEMBERSHIP #__________________SSA membership is required for group insurance policy.
          I hereby apply for active membership in the Associated Glider Clubs of Southern California (AGCSC), established in 1931.  I will arrange to pay my initiation fee of $250.00 ($125 for the Junior) to the club treasurer. This fee will be refunded should my application be rejected by the AGCSC Board of Directors. This initiation fee is your “buy-in” to the club. It permits the club to purchase and maintain the quality of our fleet of gliders for the use and enjoyment of all members.
          I understand the basic membership dues are $15.00 per month. Active flight group members pay an additional fee of $25.00 per month, and a $30 per month for insurance billed quarterly. This pays for full liability and property insurance for our gliders and other equipment. We enjoy very favorable insurance rates due to the enrollment of our members in the Soaring Society of America. This membership also provides you with the monthly magazine of the SSA, SOARING, a valuable source of information and illustrated articles about our sport.

          We have had to institute an insurance fee of thirty dollars per month until membership growth allows us to cancel this fee.  

          I agree to read and follow the By-laws and rules of the AGCSC. In addition to time spent flying and assisting the flight operations, I agree to devote an average of 4 hours per month on projects, work parties, or maintenance designed to further the stated goals of the Club. “The goal of our club is to allow members to soar in a safe, enjoyable and economical environment”.
          In consideration of the approval of this application and receiving of the proposed flight training, use of the club gliders and equipment, plus the professional, aeronautical and personal benefits to be gained, I voluntarily assume all risk of accidents or damage to my person or property, and do hereby for myself, my heirs, executors and administrators, release the Associated Glider Clubs of Southern California, Ltd. (together with it’s officers, agents and employees) from all claims, demands and causes of action resulting in personal harm during the glider flying activities.  I hereby release, waive and discharge the AGCSC and each of its members from any and all liability due to any accident resulting in death or injury, or personal property damage sustained as a participant in the activities of the AGCSC.
 Don't ask what the world needs. Ask what makes you come alive, and go do it. Because what the world needs is people who have come alive." - Howard Thurman
Complete the following if applicant is a MINOR.
NAME OF MINOR____________________________________YOUR RELATIONSHIP________________
I___________________________ (Print name) ______, as legal guardian for named minor, do hereby give my consent to his/her joining the AGCSC under the conditions stated above.
Please tell us about yourself and include any special abilities you might have that would contribute to growing and improving the AGCSC.
Flying experience_______________________________________________________________________
Have you ever damaged and airplane or had a license revoked? _______If yes please attach a statement.
Where did you learn about the AGCSC? ____________________________________________________
What is it about soaring that makes you want to learn to fly? ____________________________________
COMPLETED APPLICATIONS MAY BE SUBMITTED AT CLUB MEETINGS OR MAILED TO THE AGCSC MEMBERSHIP CHAIRMAN: Please call Rolf Schulze at 619.838.3855 or Bud Robinson at 619.436.8010 if you have any questions.