Aust_NZ_Registration

Registration Form

Please fill in all details below. * = Required Information.
Use your "Tab" key to move from box to box.

Pilot Name: ^*
HGFA No: ^* or NZHGPA No: ^*

Rating and Endorsements:^*

My HGFA or NZHGPA membership is up to date:^* Tick for Yes

E-mail: ^*

Phone No: (including area code) ^*

Mobile No: ^*

Skype Name or ID:

Address:^*

Suburb & City:^*

State: Post Code: ^*

Your D.O.B: ^*

In case of an emergency, who should we contact?

Name: ^*

Relationship to you: ^* Phone No: ^*

Full Address:

Equipment Information.

Type Of Paramotor, PHG or Microlight & Colour:

Type Of Wing: Colours Of Wing:

Type Of Wheelbase:

Is there any specific information or requirements we should know about?

Your rego fee includes a Championship jacket.

Please indicate your size requirement
in the box below.

If you would like to purchase additional jackets,
please also indicate how many extra jackets and the
sizes required in the box below.

ORDERS MUST BE IN BY 20TH OF MARCH, TO RECEIVE YOUR JACKET AT THE EVENT. ANY LATER AND YOU WILL BE UP FOR ADDITIONAL POSTAGE COSTS.

Will you be camping at the airfield during the event?
^* Tick for Yes (No additional charges)

New Zealand Pilots must take out Visiting Pilot Membership
with the HGFA. This is an additional $49.00 for 2 months.
To do this, please download the following file.
Fill it in, sign, scan & send to events@ppgaustralia.com

HGFA_Waiver.pdf

You must also put a "1" in the Visiting Pilot Membership box below.
Your membership card will be issued to you at the event.
It will be valid from the 20th April to the 20th June 2011.

Please fill in any additional items required, in the table below.
Total fees payable will be indicated and payment can
then be made by bank transfer or PayPal.

Use your "Tab" key to move from box to box, leaving the box blank if none are required.

	Quantity	$ Each	Sub_Total

Event Registration Fee.		$60.00	$
For HGFA - Visiting Pilot Membership. Please put a "1" in this box. (NZ Pilots only)		$49.00	$
How many additional event Jackets would you like to buy? Courtesy of Adrian & Helen Clarke of Hel's Bells Clothing.		$40.00	$

This button will open a PayPal page that asks for a donation amount. Please put in the total indicated here and click "Update Totals". Then continue the payment procedure. Please return to this page and complete your registration form - Thank you.	Total = $

Have you paid your fees by... ^1./ PayPal. OR ^2./ Bank Transfer. Account Name: PPG Australia - Commonwealth Bank BSB: 062 207 ACC: 1009 0957 Please put your HGFA or NZHGPA number as the transfer ID.

Be sure to read the following carefully. It pertains to your involvement in the Australia/NewZealand competition & fly-in. An event
being hosted at Jaspers Brush Airfield NSW from April 22nd to 26th 2011 by Parapro NZ, PPG Australia.com, The NSW Sky Hawks &
the Pico Club, as well as other persons, organisation and companies that have made this event possible.

I, ^* (FULL NAME), willingly assume full responsibility for the risks
that I am exposing myself to and accept full responsibility for any injury or death to myself
that may result from my participation in, presence at and observation of any activities at this event.
I FOREVER RELEASE AND DISCHARGE the event organisers and all other parties,
including their owners, officers, directors, agents, spouses, family, employees, officials (elected or otherwise),
members, independent contractors, subcontractors, lessors and lessees, spectators, pilots, assistants,
drivers, instructors, observers, and owners of aviation equipment, from any and all liabilities,
claims, demands, or causes of action that I, my personal representatives, heirs, executors, next of kin,
spouses, minor children and assigns, may hereafter have for any sports injuries or death,
however caused (whether passive or active), to the fullest extent allowed by law.

READ, UNDERSTAND, and AGREE to the Australia/New Zealand event Release/Waiver
and confirm my registration of my own free will.