ROCKY MOUNTAIN PYROTECHNICS GUILD (RMPG)

Application for Membership

Name ______________________________________________ Date of Birth __________________

Street Address _____________________________________________________________________

City, State, Zip ___________________________________ Email ____________________________

Home Phone __________________ Work Phone __________________ Cell ___________________

Name of member/s recommending you __________________________________________________

Names and Date of Birth for additional members of your immediate family attending club functions.

__________________________________________ ___________________________________________

__________________________________________ ___________________________________________

I certify that the information in this application is true. I am enclosing (please check one):

_____ $150. ($50. Single annual dues plus $100. Initiation fee). 1 vote, 1 member attending functions

_____ $185. ($85. Family annual dues plus $100. Initiation fee). 2 votes, all immediate family (under 21) attending functions

_____ $25. RMPG Supporting Member (Annual dues which can be applied toward a Single or Family membership. No signature or copy of driver’s license required for Supporting Members.)

_____ Donations beyond or instead of membership are tax deductible. RMPG is a 501c3 Charitable Organization.

Initial Membership Applicants must be at least 18 years of age.

DISCLAIMER: By signing this application, Registrants agree to indemnify and hold harmless the Rocky Mountain Pyrotechnics Guild and each of its members, directors, officers, and successors from and against all claims, damages, injuries or consequences arising out of any direct and/or indirect or collateral participation in activities associated with Rocky Mountain Pyrotechnics Guild, including displays, demonstrations, seminar attendance, hands on training, educational material (including all processes and products covered in such displays, demonstrations, seminars, training and educational materials) and other activities by the undersigned person/s and for their minor children.

            Registrants have read and agree to follow and be bound by those Bylaws and Safety guidelines .

            Registrants further agree to the possibility of background checks in accordance with the RMPG Bylaws, Colorado State Laws and the United States Code of Federal Regulations.

            Failure to comply with the Bylaws and Safety Guidelines may result in revocation of all privileges and/or removal from said event or premises as decided by the Safety Director or any RMPG Officer.

Signature of Initial Member: _________________________________________ Date: __________________

Signature of Voting Spouse: _________________________________________ Date: __________________

Send completed and signed application form with your check and a copy of your driver’s license to:

                                    RMPG

                                    6148 Iris Way

                                    Arvada, CO 80004