MEMBERSHIP AGREEMENT:
Enrollment into the Emergency Airlift membership program entitles its members to services consisting of emergency, doctor approved, closest hospital, medically necessary air transportation, by Emergency Airlift. The air transportation services will include attendant care by state certified trained technicians. Ground transportation and services provided by any heath care provider other than Emergency Airlift will not be covered. All services must originate or terminate within the boundaries served by Emergency Airlift.

FEE:
Annual membership fee is *$25. Emergency Airlift agrees to provide the services prescribed herein to the enrolled member, members spouse and eligible unmarried family members who live at the same address and are listed on your income tax as legal dependents.
PROTECTION IN EXCESS OF INSURANCE

PROTECTION IN EXCESS OF INSURANCE COVERAGE:
The protection provided by this membership is in excess of existing insurance coverage, or any other applicable benefits to which a member is entitled to at the time of claim. Emergency Airlift agrees to collect directly from any agency or insurance company whatever benefits are available. All fees and charges for services by Emergency Airlift pursuant to this agreement and in excess of the insurance and other benefits available to the member are automatically covered by the membership without additional charge. Any such proceeds received directly by the member from an insurer or other entity providing applicable benefits, shall be held in trust by the member for the benefit of Emergency Airlift and shall be tendered to Emergency Airlift immediately upon receipt thereof by the member. Membership is not solicited from persons who receive welfare medical benefits and such membership constitutes a voluntary contribution only.

SERVICE AREA:
Currently Emergency Airlift is servicing Oregon, Southwestern Washington and Northern California based hospitals only.

ENTIRE CONTRACT-CHANGES:
This membership form including endorsement and enrollment form constitutes the entire agreement between the parties. No change shall be valid until approved by an executive officer of Emergency Airlift and unless such approval be endorsed hereon or attached hereto.
No agent has authority to change this policy or waive any of its provisions.
In the event Emergency Airlift shall be unable to perform or complete any flight due to any cause beyond its control, Emergency Airlift may elect to terminate this contract without liability for penalties or damages.

EFFECTIVE DATE OF AGREEMENT:
Membership is effective 30 days after receipt of the completed agreement and fee by Emergency Airlift, and expires 12 months from that date. Continued membership is dependent upon the annual renewal.

MEMBERSHIP CARDS:
You, your spouse and the legal dependents you list on this form will receive a membership card by mail after your membership has been processed. It takes approximately 30 days to process your membership.

ASSIGNMENT:
The member affixing his or her name hereunder thereby assigns all rights and interest in and to any insurance or other third party benefits payable to member for services provided by Emergency Airlift, pursuant to this agreement. I understand that violations of the terms of this agreement may result in immediate cancellation. This membership is non-refundable and non-transferable.