Backcountry Membership notice of Interest

Fill out this form to let us know you're interested in joining the club. We'll follow up shortly to share more information with you.

Name *
Name
Phone
Phone
Address
Address
Birthdate
Birthdate
Emergency contact mobile number:
Emergency contact mobile number:
Do you have at least 50 hours PIC time?
Do you currently hold a tailwheel rating?
Do you have at least 15 hours in tailwheel aircraft?
Are you checked out to fly a Summit tailwheel plane?