AMERICAN CANARY FANCIERS ASSOCIATION ~  MEMBERSHIP APPLICATION

New members  q                     Renewal   q                     New address   q                  New Phone   q 

Name: (please print)____________________________________________________________________________

Address:___________________________________________________________________________________

City:________________________________________  State: ____________   Zip:_________________

Telephone:________________________________________ 

E-mail:________________________________________________________ 

Please check the birds you breed

____Border        ____Berner                     ____Belgian Fancy       ____Columbus Fancy      ____Melanin New Color                            

____Gloster       ____American  Singer      ____Scot Fancy           ____Lizards                    ____Stafford   

____Yorkshire   ____Timbrados                ____ Lancashire           ____Lipochrome              ____Hartz  

_____Norwich    ____Frills                        ____Fife                      ____Melanin Classics         ____Old Crested/CrestBred  

*Monthly Newsletter                                                                 (Membership year runs from Jan 1st for Dec 31st)

*Purchase of ACFA Leg Bands

*Free Show Catalog at Show or mailed by request

 

Make checks payable to: ACFA

And Mail To:   Carlos Ponce

                     619 W Elm Ave

                     Fullerton, CA 92832

                     Phone: 714-738-8671

 

Questions? Email:

 FULL RELEASE OF ALL CLAIMS

In consideration of my participation in the AMERICAN  CANARY FANCIERS ASSOCIATION and any  and all of its events, I, the undersigned, intending to be legally bound, for myself, my heirs, executors and administrators, do hereby fully and finally waive, release, and hold harmless, the  AMERICAN  CANARY FANCIERS ASSOCIATION and their respective directors, officers, employees, members, agents, and assignees, from any and all responsibility, claims, causes of action, injuries, judgments, or other damages of any nature whatsoever, including but not limited to, any personal injuries I might suffer, directly or indirectly, resulting from my participation in, or travel to and from the aforesaid activity.

By signing below, I swear that I am 18 years old or older and will accept the By-laws and terms and conditions of membership and have read the Articles of Incorporation. I acknowledge that I am engaging in the aforesaid activity, and knowingly executing this release, at my insistence, and request, and that I voluntarily do so without coercion whatsoever. Note: You may wish to print a copy of the By-laws for future reference 

SIGNATURE:_______________________________________________________________________