FCKC Membership application

Flying Club of Kansas City Membership Application
The Flying Club of Kansas City offers two types of Memberships: Individual and Family. Family memberships allow immediate family members, living in the same residence as the primary Member, use of the Club aircraft and other assets. Individual memberships can be upgraded to family memberships at any time by paying the difference in applicable Membership fees, as in effect at the time of upgrade.

Membership Fee:
For an individual Membership, an initial Membership Fee of $3,000 must be submitted upon approval. For a family membership, an initial Membership Fee of $3,000 plus and additional $2,000 per family member must be submitted. Individual memberships are available for those under 18 years of age. However, a parent/legal guardian must sign the application.

The initial Membership Fee can be paid via ACH or Credit card and is NON REFUNDABLE.

Monthly Dues:
Members are obligated to pay certain Monthly Dues, which cover the Club’s fixed expenses, including capital costs, insurance, hangar and office rent, fixed maintenance expenses, etc. The amount of the Monthly Dues is fixed by the Board of Directors and is adjusted from time-to-time. For information on the current Monthly Dues amount, please contact the Club manager or see the Club website.

Aircraft Rates and Payment Terms:
Aircraft time is billed on a dry basis, based on the Hobbs meter, with the Member responsible for refilling the airplane based on a fixed number of gallons per hour (or paying the Club for the applicable number of gallons at the current Club fuel rate).

Resignation of Membership:
Upon written request and 30 days notice to the Club Manager, the Board of Directors will accept any request for resignation of Membership. Additionally, the Board of Directors may terminate the membership of any member who, in the Board of Directors sole opinion, operates any Club aircraft in a careless, reckless or unsafe manner; who is fails pay his or her bills in a timely manner; or who fails to meaningfully participate as a Member of the club.

Application Procedure:
Complete the following application and covenant not to sue. Submit them along with a copy of your pilot certificate(s), FAA medical certificate or BasicMed documents, driver’s license, last page of your logbook showing totaled hours, and logbook page showing your last biennial flight review to the addresses below. Student pilots will also need to provide a copy of their current passport or birth certificate.

Email: President@flyingclubkansascity.org AND Manager@flyingclubkansascity.org with any questions
Type of Membership:

Individual ($3,000)Family ($2,000):Add on to Family (contact board)
Applicants Name

First NameLast Name
Spouse

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth

MonthDayYear
Date
E-mail
Cell Phone Number

Area CodePhone Number
DL State AND Number
State / Number
DL Exp Date

MonthDayYear
Date
Certificate Type
Airman Certification Number
Airman Cert Issue Date

MonthDayYear
Date
Ratings
Most recent FAA flight review

MonthDayYear
Date
Medical
Date Medical of Issuance

MonthDayYear
Date
Any Waivers

YesNo
Please Explain Waiver (if yes)

	In Hours
Total Hours
PIC
Last 12 Months
Instrument
Complex
Solo (If Student)
Dual (If Student)

TERMS (READ CAREFULLY):

By my signature, I petition the Board of KCN Aero Club, Inc. (the “Flying Club of Kansas City” or the “Club”) for membership. I have read and fully understand all of the terms of Membership. If accepted, I agree to abide by all Federal Aviation Administration regulations and to follow all Club rules and regulations, as set forth herein and in the Club Bylaws and Operations Manual. My Membership in the Club, and my right to use Club aircraft, shall not begin until this application has been approved by the Board of Directors and the applicable Membership fees have been paid in full. I UNDERSTAND THAT UPON ACCEPTANCE OF THIS APPLICATION BY THE BOARD OF DIRECTORS, THIS FEE IS NOT REFUNDABLE I understand and agree to the billing procedures of the Club, as set by the Board of Directors from time to time and expressed in the Club Bylaws and Operations Manual, and I agree to pay all charges incurred and assessed against my account with the Club. I further understand that I am responsible for all dues, assessments, incurred flight time and fuel charges, and any other properly assessed amounts until I properly resign my Membership pursuant to Club policy. I acknowledge that failure to pay amounts due and owing may result in suspension of flight privileges, termination of my Membership, and the initiation of collection efforts. I do hereby agree to hold harmless the Flying Club of Kansas City., its directors, officers and employees, and to assume all responsibility for and to defend, pay or otherwise settle all claims, demands, actions or equity for loss damage or injury to any to any and all persons and property arising out of such use by me. Finally, I agree that in the event I am determined to be at fault in an accident or incident which occurs while I am operating a Club aircraft (in the air or on the ground, in motion or not in motion), I will pay the Club the cost of the repairs, up to a maximum of $2,500.
The information contained herein is true and correct as of the date set forth opposite my signature on this application. I hereby authorize the Flying Club of Kansas City, Inc to contact credit reporting agencies and creditors to obtain my credit history.
Signature

Clear
Date

MonthDayYear
Date
Is the Applicant under 18 years of age

YesNo
I am the parent / legal guardian of {applicantsName}
who is applying for membership in the Flying Club of Kansas City. I hereby agree to be bound to all terms and conditions stated above.
Name of parent / legal guardian

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
Board Approval Signatures Below

KCN Aero Club inc.
dba
FLYING CLUB OF KANSAS CITY
P.O. Box 24081
Overland Park KS 66283-4081
COVENANT NOT TO SUE
I,

First NameLast Name
am about to participate voluntarily in various activities, including flying activities, of the Flying Club of Kansas City as a pilot, student pilot, instructor, or passenger. In consideration of the Club permitting me to participate in these activities, I, for my heirs, administrators, executors, and assignees, hereby covenant and agree that I will never institute, prosecute, or in any way aid in the institution or prosecution of any demand, claim or suit against Flying Club of Kansas City or its officers, agents, or employees, acting officially or otherwise, for any loss, damage, or injury to my
person (including death), or my property which may occur from any cause whatsoever as a result of participation in the flying club.

If I or my heirs, administrators, executor, and assignees should demand, claim, sue or aid in any way in such a demand, claim or suit, I agree to indemnify the Flying Club of Kansas City for all damages, expenses and cost it may incur as a result thereof.

I understand and agree that I am assuming the risk of any personal injury or property damage to me that may result while participating in Club activities, including such injuries or damage that may be caused by the negligence of Flying Club of Kansas City.

I also understand and agree that I may be held liable for any damage or loss to Flying Club of Kansas City. which is caused by my gross negligence, willful misconduct, or fraud.

The term Flying Club of Kansas City includes individual members and any officer, agent or employee of the Flying Club of Kansas City or KCN Aero Club, inc., acting officially or
Date

MonthDayYear
Date
Signature of applicant

Clear
Signature of spouse

Clear
Is the Applicant under 18 years of age

YesNo
I,

First NameLast Name
hereby accept the terms specified above for the following minors who are under my care, custody and control for the purposes outline in the above documentation. (As passengers or pilot)
Date

MonthDayYear
Date
Signature of Parent or Guardian

Clear

Are you A Student Pilot

YesNo, I have my Pilots license
Please Upload a copy of your Birth Certificate or Passport

Browse Files

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Please Upload a Copy of your pilot certificate(s)

Browse Files

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Please upload a copy of your FAA medical or BasicMed Documents

Browse Files

Cancelof
Please upload a copy of your drivers license

Browse Files

Cancelof
Please upload a copy of the last page of your logbook showing your total hours

Browse Files

Cancelof
Please upload a copy of your logbook showing your last beinnial flight review

Browse Files

Cancelof
Should be Empty:

	Yes	No
Aircraft accident/incident
Airman Certificate Suspended
Aviation Insurance Declined or Canceled
Driver’s License Suspended or Revoked
Violation of FAR
Arrested for DWI/DUI
Auto Accidents last 5 years

Flying Club of Kansas City Membership Application

Flying Club of Kansas City Membership Application