YOUNG EAGLES REGISTRATION FORM

INSTRUCTIONS: Complete this form and give it to your volunteer pilot. Make sure the permission form is completed, and signed.

PLEASE PRINT  (IN INK)  LIKE THIS:   A  B  C  D  E  F  G  H  I  J  K         1  2  3  4  5       


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NAME OF PARTICIPANT ( LAST, FIRST,  MIDDLE INITIAL )


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ADDRESS


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CITY


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STATE/PROVINCE  

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ZIP/POSTAL CODE

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DATE OF BIRTH (MONTH/DAY/YEAR)

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TELEPHONE


*Have you ever participated in a Young Eagles Flight before?     YES________ NO________

* NOTE: Prior participation does not prohibit additional flights, but program goals give priority to new participants. Registration and benefits will occur only once.

                EAGLE FLIGHT PARENT/GUARDIAN PERMISSION FORM
The Eagle Flight candidate named above wishes to participate in the EAA Young Eagles Program, which includes a demonstration flight.  I certify that I am the childs legal guardian, and give him/her permission to participate in this program. I also agree to hold the EAA Aviation Foundation, Inc., Experimental Aircraft Association, Inc., all participants and sponsors harmless for all personal injury which might result from participation in any part of this program.







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Parent/Guardian Signature