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NAMES OF FAMILY MEMBERS_________________________________________

_____________________________________________________________________

ADDRESS____________________________________________________________

_____________________________________________________________________

PHONE______________________________________________________________

EMAIL ADDRESS (ex. user@host.com) ____________________________________

How did you hear about ConnectiKITERS?__________________________________

____________________________________________________________________

What type of kites do you fly? (circle all that apply)

Single line - Dual line - Quad line - Fighter

Other________________________________________________________________

Are you a member of the American Kitefliers Association?

Yes - No

If no, Do you plan to become a member of the AKA?

Yes - No

Do you make kites?

Yes - No

As a member, what could you add to the club?

___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

Send to:
ConnectiKITERS
55 Rochdale Terrace
West Haven, CT 06516
USA

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