Yankee Flyers Dog & Disc Club

Website- www.YankeeFlyers.com

Membership application – Yearly Membership

New Membership check one: Single - $25.00 Family - $35.00

Membership Renewal check one: Single - $20.00 Family - $30.00

(Renewal membership is for one year from date of submitted new membership form)

Please make checks payable to YFDDC and send to:

YFDDC c/o Carrie Neri, 65 Music Vale Rd, Salem, CT 06420 or email:

Primary Handler information

First, Last Name:
Street Address:
City/State/Zip:
Home Phone #: / Cell #:
e-mail:

Secondary Handlers/Juniors or Others in same household:Fill in age if Jr. (15 or under)

1. First, Last Name: / Age
2. First, Last Name: / Age
3. First, Last Name: / Age

Disc Dogs Information

1. Dog’s name: / Breed / Approximate DOB
2. Dog’s name: / Breed / Approximate DOB
3. Dog’s name: / Breed / Approximate DOB

Rabies Vaccine Information – ** Please bring a copy of your dog’s valid rabies certificate to events! **

Please indicate how you would like to receive information and communication from YFDDC

Please Check One: Via E-Mail Via our Facebook group or Other (indicate):

Release and Waiver of Liability

This release must be signed by any new or renewing YFDDC member.

In consideration of my membership in the Yankee Flyers Dog & Disc Club (YFDDC), I the undersigned, intending to be legally bound, do herby for myself, my heirs, executors, and administrators, waive and release any and all claims for damages which I may have against any community or property owner where a YFDDC event is held, the Yankee Flyers Dog & Disc Club, their representatives, successors, employees, assignees and/or sponsors for any and all injuries or illnesses suffered by me or my dog(s) as a result of my participation in any YFDDC function or YFDDC sanctioned event. I attest and verify that my dog is physically fit for canine disc competition and hereby assume the risk of any injury or canine disease which may occur or be contracted in the said event. By my signature I also grant my full permission to the Yankee Flyers Dog & Disc Club and it’s assignees to use any photographs, videotapes, motion pictures, recordings or any record of any event held by the Yankee Flyers Dog Disc club for any purpose whatsoever. I the undersigned agree to abide by the club’s bylaws.

Print Name / Signature / Date
Print Name / Signature / Date
Print Name / Signature / Date
Parent/Guardian (if under 18)

All new or lapsed members must get 2 club member sponsors not of the same household for the first year of membership. Memberships are considered lapsed if not renewed within 1 month after your renewal date.

Sponsor #1 / Sponsor #2