EVENT ENTRY FORM

EVENT:

Pilot's name: Phone:

Address:

City: Prov.: Country: Postal Code:

HPAC Member #: HPAC Insured? Yes No     Provincial/Nation Association:

Pilot Experience (airtime): (hrs)   Flights   HPAC Rating:

FAI Sporting Licence:

Pilot Information (for Media Release e.g. credentials, achievements, etc.):

 

 

 

In Case of Emergency, Contact:

Name: Phone:

Address:

City: Prov.: Country: Postal Code:

 

Aircraft Type (HG or PG), Make, Model:

 

Markings and Colors:

 

 

Entry Fee$ Miscellaneous fees (specify)
HPAC Insured Member Fee$ HPAC Fees are found on the HPAC Membership Application Form
(Membership Cheques may be made Payable to HPAC)
Foreign Resident Insurance$ CDN 40.00
FAI Sporting Licence (optional)$ 50.00
TOTAL FEES$

 

Note: HPAC Insurance, Helmets, Parachutes and Certified Gliders are Mandatory. HPAC Short term (3 months) insurance is available for foreign residents (only) for CDN $40.00. Make cheques or money orders payable to HPAC.

 

HPAC Form C-12 Rev 1 2013-03