New Member Checklist

Use the following checklist to sign up new members. Submit this form with the new member information after
checking off completed steps.

New Member Name: __________________________________

Instructor/Employee should do the following to sign up a member:

❑ US Citizen ○ YES
❑ Verify Citizenship by getting copies of either A or B:
❑ A) Passport
or
❑ B) Driver's License AND Birth Certificate (MUST HAVE SEAL)
❑ US Citizen ○ NO ***Student cannot log any flight time prior to getting TSA approval***
❑ Direct PPL, IFR, or ME foreign students to AFSP website to apply for permission to flight train:
www.flightschoolcandidates.gov
❑ At first lesson:
o Take photo of student and text it to Office (Photo must be uploaded to AFSP site within 5
days of lesson)
o Get copy of passport
o CFI or staff should initial and date the passport copy

❑ Get copies of any that apply

❑ Pilot's License
❑ Medical
❑ Most recent BFR signoff in logbook
❑ Instrument currency in logbook

❑ New member must fill out... (Make copy for member if they wish)
❑ Membership Application - fill out, sign, date
❑ Membership Agreement - fill in blanks, sign, date
❑ Notice of Insurance Coverage - sign, date

❑ Collect member deposit (Group I=$1200; II=$1500; III=$2500)

❑ Check (made out to “T&G Flying Club Trust”) or Cash (No credit cards, please)

❑ Give member the packet of club policies

Office
❑ Create user ID in Schedule Master and call member with ID and password
❑ Record deposit in Trust book
❑ Create new member file

Page 1 of 6
Membership Application
PERSONAL
Todd Barnhart
Name: ___________________________________ Emergency Contact: ________________________
15665 Gamekeepers Trl
Address: ___________________________________ Relation to Applicant: ______________________
___________________________________
Novelty ohio 44072 Address: _________________________________
___________________________________ _________________________________
440
Phone: Home (____)__________________________ _________________________________
Work ( )__________________________ Phone: Home (____)________________________
E-mail _______________________________ Work ( )_______________________
Cell _______________________________
Pager _______________________________
U.S. Citizen ○ Yes ○ No
Date of Birth: _______________________________ Pilot Certificate #: _________________________
Drivers License #: _________________________

EMPLOYMENT
Employer: __________________________________
Address: __________________________________
__________________________________
__________________________________
Phone: (____)____________________Ext.______

FLIGHT EXPERIENCE
Dates: Last Medical: __________ Class: ________ Last BFR/AFR: _______ IFR Comp: ____________
Last Certificate/Rating: _____________________________________ Date: ________________________
Licenses & Ratings currently held: __________________________________________________________

List total hours by make & model:

Fixed Gear Retract Gear Fixed Gear Retract Gear
Cessna (150-177) _________ _________ Beechcraft _________ _________
Cessna (180-210) _________ _________ Taildragger _________ _________
Piper 200 h.p.> _________ _________ Multiengine _________ _________
Piper 201 h.p.< _________ _________ Mooney _________ _________
Others: __________ _________ _________
_______________ _________ _________ __________ _________ _________
Total Flying Time: __________

AVIATION HISTORY
Accidents/Incidents: _______________________________________________________________________

References:

Any accident/violation history withheld is grounds for dismissal from the club. I have read and disclosed the above
information to the best of my knowledge.
Date: ____________ Signature: ___________________________
Print Name: __________________________
Signed up by __________________
Member #: _________ (to be filled in by T&G)

Page 2 of 6
 T&G FLYING CLUB, INC.
MEMBERSHIP AGREEMENT
T&G Flying Club, Inc. (hereinafter "T&G) accepts
$ ________________ as a membership deposit, along with a
completed application from _______________________
(hereinafter "member"). This membership entitles the member
to fly aircraft in Group _____, provided the member is
appropriately certified, meets T&G's insurance company
requirements (see "Notice of Insurance Coverage"), and has a
proper endorsement by a certified T&G flight instructor in the
member's pilot logbook for each make and model of club
aircraft to be flown. All membership deposits are held by T&G
Flying Club Trust account. There is no interest paid or accrued
to the member.
Groups: The member may upgrade his/her membership to a
higher category by paying T&G the difference in his/her
membership deposit for the higher category (see current rate
sheet by group). If an aircraft is flown in a higher group than
the member belongs, the member will be charged an additional
hourly rate.
Account Payment: The member agrees not to let his/her
balance due to T&G exceed the original membership deposit.
The membership deposit acts as a credit limit. It is the
responsibility of the member to keep his/her account balance
below the deposit amount at all times.
The member agrees to pay in full his/her T&G monthly
statement. The balance must be paid before the last banking
day of the month in which the statement is received. Unpaid
balances will incur a service charge of 1.5% per month.
Termination: The member reserves the right to withdraw from
T&G at any time after a period of six months, provided written
notice is given. Termination will be effective at the end of the
month in which notice is given. If a member terminates within
the first 6 months, T&G will withhold 6 months dues from the
deposit. T&G reserves the right to terminate the member at any
time provided written notice is given. Either party may
terminate this agreement without specifying a reason.
Within 45 days of termination of this agreement by either party,
T&G will return the membership deposit, less any outstanding
charges (e.g. unpaid dues, aircraft rental charges, flight
instruction charges, damages to aircraft not covered by
insurance, items on loan, pilot supplies).
Liability: The member agrees that T&G, its officers, directors,
employees, agents, and assigns are not responsible and shall
have no liability for any and all losses, costs, attorney's fees,
judgments, settlements arising from claims, actions, causes of
action, demands, damages, or expenses for personal or bodily
injury to or death of person(s), loss of consortium, loss of
services and loss of or damage to property due to the member's
erroneous, improper or negligent possession, entrustment,
flight, use or operation of any aircraft owned or leased by T&G.
The member agrees to indemnify and hold harmless T&G, its
officers, directors, employees, agents, and assigns from any and
all damages including, but not limited to, the member's
erroneous, improper, or negligent possession, entrustment,
flight, use or operation of any aircraft owned or leased by T&G.
The member further agrees that T&G and its fellow members
are not liable for any damages if a flight cannot be started or
finished as intended.
Damages: T&G for itself, its officers, directors, employees,
agents, assigns, and anyone acting for the club on its behalf,
waives the right to subrogation for any valid and collectable
insurance loss.
A member may not get his/her deposit returned if he/she is
involved with a damage incident of a club aircraft until such
time all damages are repaired and all other obligations to the
club as a result of the damages are settled. In addition to
damages, a renter is responsible for the loss of use of an aircraft
that is disabled for any damages while the aircraft is in his/her
care and custody. The loss of use will be calculated at the rate
of 1% per month of the book value plus 50% of the monthly
insurance premium until the aircraft is returned to service or the
owner receives a check from the insurance company. In no case
will the damages claimed by T&G exceed two times the deposit
amount for that category of aircraft.
Documentation: Members who wish to solo a T&G aircraft
shall have one or more of the following, as appropriate, for the
intended flight: a current Federal Aviation Administration
(FAA) pilot certificate with the appropriate ratings, a medical
certificate of the appropriate class, a biennial flight review per
the Federal Aviation Regulation (FAR) requirements, an annual
T&G proficiency check, meet FAR currency requirements, and
when applicable, a T&G 6-month instrument proficiency check.
Copies of appropriate logbook signoffs, medical, and other
documents must be on file and kept current in the T&G office,
documenting compliance with the above requirements for the
member to maintain flying privileges. The member agrees not
to permit any person, who is not fully qualified in accordance
with all laws and all T&G requirements, to fly any T&G
aircraft.
Operations: The member agrees to use the aircraft only for
lawful purposes and to abide by all Federal Aviation
Regulations (FAR), T&G regulations, local, state, and federal
laws, statutes, and regulations as well as good operating
practices and procedures. The member agrees not to fly any
aircraft which, upon preflight inspection and review of prior
squawked discrepancies, does not appear to be in proper
operating condition for the intended flight or is otherwise not
airworthy. In addition, the member agrees to abide by all
regulations at each airport of intended use.
Rates: The hourly aircraft rental rates, monthly dues, and
membership deposit amounts are described in the current
membership rate sheet. All of these prices are subject to change
and may be retroactive to the first day of the month in which
notice is given.
The undersigned member has read and understands the T&G
agreement and acknowledges receipt of the "Rental Policy" and
current rate sheet.
Signed: ____________________________________________________
Member Signature Date
Print: ______________________________________________________
Member Name
Accepted by: ________________________________________________
Page 3 of 6
Notice of Insurance Coverage
Per section 4561.25 of the Ohio Revised Code, you are notified that, as a member of T&G Flying Club, Inc.:

1) You are insured under a policy of insurance coverage provided by T&G Flying Club and providing liability coverage (to
T&G Flying Club members). Coverage is in the following amounts:
- $1,000,000 combined single limit bodily injury and property damage with a limitation of $100,000 per passenger.

2) Waiver of subrogation is provided by the insurance company for aircraft that have hull coverage.

3) The following aircraft are not covered by hull insurance:

- All Group I Aircraft
- Group II Aircraft: 154AV, 4889D, 53491

MINIMUM PILOT EXPERIENCE REQUIREMENTS (in hours)

Renters (excluding flight instructors)

Single Engine – Fixed Gear

Aircraft Total Time Retract Make/Model Minimum
Type Time License
200 HP or None None Checkout Student
Less
201-235 HP 100 None Checkout Private
236+ HP 250 None 10 Private

Single Engine – Retractable Gear

Aircraft Total Time Retract Make/Model Minimum
Type Time License
200 HP or 125 20 or 10 dual Private
Less
201-235 HP 175 20 or 10 dual Private
236+ HP 250 20 10 dual Private

Multi Engine
Aircraft Total Time Retract Make/Model Multi- Minimum
Type Time Engine License
Up to 570 500 25 and 20 dual Or 50 MEL/Instru.
HP

In addition to the minimum hour requirements, you must be checked out and signed off for each make and
model by a qualified CFI.

As a member of T&G Flying Club, I understand that I have the above stated insurance coverage:

Signed: ______________________ Print: _______________________ Date: ____________

Page 4 of 6
Credit Card Form
Date: ________________

I authorize T&G Flying Club, Inc. to charge my credit card for T&G related expenses. When my credit card expires,
I will inform T&G Flying Club, Inc. of any new required information.

Name: ____________________________________________________
Print (First, Last)

Name: ____________________________________________________
Signature

Credit Card Type: VISA MASTERCARD DISCOVER AMERICAN EXPRESS

Credit Card Number: ________________________________________

Expiration (MM/YY): _______________

Security Code: ____________

Billing Address: _____________________________________

_____________________________________

Office: (Photocopy front/back of credit card)

Page 5 of 6
Schedule Master Information
Name: ______________________________

Your Username is: ________________ Your Password is: ______________

Internet Access
Point your browser to: http://www.schedulemaster.com/smlogin.htm

We’ve worked to make the service intuitive and easy to operate. If you have any questions, please feel free to
contact us at: support@timesync.com

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