Henry Schafer

113 Allen St

Waterloo, IA 50701-2605

Phone 319-235-0721

Check dates you will attend:

o                January 7, 2012 (Saturday)

o                January 8, 2012 (Sunday)

Make checks payable to: “Black Hawk R/C Pilots”

Pilot Registration - AMA Adult, Park Pilot or Open members

$25 for one day

$40 for both days

Pilot Registration - AMA Youth members

$10 for one day

$18 for both days

Spectators & Assistants

$5 per day (children 12 and under are free)

Please Print

Name:_______________________________________________________________________________

AMA Number (required):______________________________________________

Address:_____________________________________________________________________________

City:________________________________________________ State:________ ZIP:________________

Phone:____________________________ Cell Phone: _________________________________________

Email:________________________________________________________________________________

Which nights do you plan to stay in Cedar Falls?   o Friday  o Saturday   o Sunday   o none

If you are spending the night in a Cedar Falls motel, which motel do you plan to stay in?

____________________________________________________________________

You must show current AMA Membership card at check-in or be pre-registered.  Pre-registration must include full payment.

All fixed wing electric aircraft must have a flying weight of less than 25 ounces.  Helicopters must have 355 mm or smaller main rotor blades.

        120v AC available.  Tables are not provided but are allowed on the stadium floor.

No refunds unless event is cancelled.