AFA_Membership_Form.doc
Please make check or Money order payable to American Fire Artists
Policy Period: May 1st, 2011 –May 1st, 2012
Membership fee: $150
First Name: Middle Initial: Last Name:
Performing as:
Address 1:
Address 2:
City: State: Zip Code:
Day Phone:
Evening Phone:
Fax:
E-mail:
MEMBERSHIP AGREEMENT OF INTEGRITY:
As a member of American Fire Artists, I (Legal Full Name PRINT)_________________________, do agree to the following:
1.) I have read and comply with the NAFAA (North American Fire Arts Association) Safety requirements.
2.) I will protect my self and my surroundings by focusing on the AVP ( Audience, Venue, Performer) standard of performance
safety and spotting.
3.) As a representing member of American fire Artists, LLC I agree to keep my performance, attitude and behavior at a
professional level while performing for the public.
4.) I understand that it is my responsibility to be prepared in the event of a claim. I will need to submit an (ICI) Incident Claim
Investigation form, as well as provide pictures and or video documentation of the issues for claim processing.
5.) I understand that American Fire Artists, LLC covers liability coverage to its active members. This does not include
Personal Injury or Workers Compensation, both of which are not covered under the policy or membership of American Fire
Artists, LLC
I agree and understand that adherence to the Agreement of Integrity is necessary and will allow for safer practices and
performances in a professional environment. I understand that as a member of American Fire Artists, Safety comes FIRST. I
respect and understand that as a member it is my responsibility to adhere and promote safety for my audience, my
spotter/safeties, my venue and myself. I understand that a violation of this agreement may include disciplinary action including
cancellation of my membership and loss of my insurance coverage.
I will contact American Fire Artists, LLC with any questions.
Signed: Mail to:
American Fire Artists. LLC
Printed: P.O. Box 16585
Raytown, MO 64133
Dated: