Glider Reservation Form
Name.................................................................
Date of Birth .........................................
Club.................................................................................................................................
Address...................................................................................................................................................................
Country............................................................................Telephone……………………………………………....
Fax..........................................................................……E-mail..............................................................................
Flying Experience
Total Flying Hours
……………………....................... Flying
Hours in Australia ……………….......
Date of your last Flight ….…………….......................
Hours flown in the last Season ......……........
Type of Aircraft flown...................................................................................................................
Do you have a current aviation medical certificate? * Yes
/ * No.
If No, please state the reason:
..........................................................................................................
Please include a copy of the last page of your logbook, if
you did not fly with us in the last season.
Badge Achievements
....................................................................................................................
Your Goal whilst in Narromine (purpose, task, etc.)
.....................................................................
TYPE OF
GLIDER REQUESTED TO BOOK
1st
Choice................................................................... 2nd Choice
..............................................................
Date commence booking
............................................. Date finish booking
........................................................
Deposit: A$ 500.00
Method of Payment:
* Bank Transfer to Soar Narromine, National Australia Bank, Narromine 082-753 Account
03-646-1861,
Swift: NATAAU3302S; (Add A$ 6.00 for banking fees to your deposit);
* A$ Bank Cheque;
* Credit Card Telephone Order [* Mastercard * Visa * Amex] (Add 5% for credit card
charges).
Date of Payment
...................................
or Details of Credit Card: Credit Card
Holder, Credit Card Number and Expiry Date
…………………………………………………………………………………………………………
Booking request valid on receipt of deposit which must be paid within 4 weeks after
reservation.
I agree to wave all claims against Soar
Narromine Pty Ltd and any person assisting in the organisation either by me or any other
person claiming through me or on my behalf for any property or personal damage whatsoever.
I agree to indemnify and hold harmless this entity and persons in respect of their actions
and inactions in carrying out any activity relating to Soar Narromine Pty Ltd or any
persons assisting in the organisation to the extent that any circumstances relating to any
claim have been contributed to by me.
I agree to pay up to a maximum of A$ 2,200.00 if a damage to a glider, its equipment or
any aircraft occurs due to my negligence or during an outlanding.
I understand, whilst flying, Soar Narromine's insurance may indemnify me as pilot in
command for all sums I shall become legally obligated to pay as damages to Third Parties
(excluding Passenger Liability) up to a maximum of
A$ 1,000,000.00 only.
I understand that participating in any activity relating to Soar Narromine Pty Ltd and any
person assisting in the organisation occurs entirely at my own risk.
Signature
....................................................................................................,
Date...............................................……
ACCOMMODATION
* Motel * Others
…………………………….…………………………………………...
* Single * Double * Triple * Non-Smoking * Smoking;
Check In Date .............… Check Out Date
...............
TRAVELLING TO NARROMINE
* By air from Sydney to Dubbo * By bus to
Narromine * By car * Others;
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