AMERICAN CANARY FANCIERS ASSOCIATION ~  MEMBERSHIP APPLICATION 

New members ____               Renewal ____              New address  ____             New Phone  ___ 

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          ____Waterslager                  

____Gloster       ____American  Singer      ____Scot Fancy           ____Lizards                    ____Stafford   

____Yorkshire   ____Timbrados                ____ Lancashire           ____Lipochrome              ____Domestic Hartz  

_____Norwich    ____Frills                        ____Fife                      ____Melanin Classics         ____Old Crested/CrestBred  

Membership Benefit                                                                 MEMBERSHIP FOR ONE YEAR . . . .   $25.00                      
*Monthly Newsletter For 11 months                                        (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:   
Ragi Abboud
5349 Overing Dr
Woodland Hills, CA 91367
818-884-6338  rabboud898@aol.com
Questions? Email: animated email envelope
 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:_______________________________________________________________________Date________________________

 

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