Registration form for the practice of Free Flight on the site of Mont Gros

Flight on-site - Cross - S.I.V. - Paraglide's Tests - Supervision pupils – Individual Pilot

Registration Groups - Schools - Clubs

Presence on the site envisaged " which period ? " ( Format: year-month-day 2012-12-20 )
Organization:	Groupe School Club
City:
Country:
* Name of the referent:
First name of the referent:
* E-mail of the referent:
* Phone number of the referent:
Number of people supervised:
Number of persons holding Brevet Drivers and IPPcard or 4:
From:	au :
Activity:	SIV Flight site Cross Other supervisation
Activity against compensation " Professionnal activity ? "	Yes Not
Do you have a VHF radio communication ?	Yes Not
If so, your frequency ?
Supervisation:
Number of Patents State:
Federal Patent number:
Safety Boat SIV - TESTING ONLY:
Registration:
Length:	m
Engine power ( HP):

Thank you fill up the form.

Fields marked with an " * " are required.

* For aerobatic activity freestyle paragliding:

Presence on the site envisaged " which period ? " ( Format: year-month-day 2012-12-20 )
* Pilot's Name:
Pilot's first name
City:
Country:
* Phone Number:
* E-mail:
Number FFVL license: " license's number "
Other license:
Patentee Driver ?	Yes Not
Have you contacted a school club or structure for a boat ?	Yes Not
If yes, which ?
From:	To:
Person to notify in case of emergency: (Required)
Name and first name:
Phone:
Check the following box: I have read Article 7 of By-law in force. As individual driver, I promise on my honor to evolve over the sea with a boat armed security, engine and driver on standby.

Thank you fill up the form.

Fields marked with an " * " are required.