ye-logo.gif    YOUNG EAGLES REGISTRATION FORM

      INSTRUCTIONS: Complete the upper portion of this form and give it to your volunteer pilot. 
      PILOT: Complete the lower portion of this form and return it as soon as possible to the Young Eagles Office.
 
    PLEASE PRINT (IN BLACK) LIKE THIS: ABCDEFGHIJKLMNOPQRSTUVWXYZ0123456789
                                               YOUNG EAGLES REGISTRATION INFORMATION

NAME OF PARTICIPANT (LAST, FIRST, MIDDLE INITIAL)

ADDRESS
   
CITY                                                                STATE/PROVINCE             ZIP/POSTAL CODE
    -- 
DATE OF BIRTH (MONTH/DAY/YEAR)          *HAVE YOU EVER PARTICIPATED IN A        TELEPHONE       
                                         YOUNG EAGLES FLIGHT BEFORE? 
                                                                                             (YES/NO)
*NOTE: Prior participation does not prohibit additional flights, but program goals give priority to new participants. 

                         YOUNG EAGLES PARENT/GUARDIAN PERMISSION FORM 
The Young Eagle 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 I give him/her permission to participate in this program. I also agree to hold the EAA Foundation, Experimental Aircraft Association, Inc., all participants and sponsors harmless for all personal injury which might result from participation in any part of this program.
___________________________________________              
Parent/Guardian Signature                                                        Sponsoring EAA Chapter or Affiliate
 
 

                  PILOT REGISTRATION INFORMATION
 

YOUNG EAGLES PILOT                 EAA NUMBER
I.D. NUMBER
 
 

NAME (Last, First, Middle Initial)
 
 

Address
 

City      State  Zip/Postal Code
 

Type of Aircraft       Date of Flight (Month/Day/Year)
 
 

EAA Chapter or Affiliate Organization    Telephone    FORM