Name: *

Surname: *

ID No: *

Pilot: *
YesNo

Date of attendance: *
From: To:

Number of additional attendees: *
(This will be the number of people ADDITIONAL to the pilot. So if the pilot brings his wife it will be 1)

Affiliation:
SAHPAOther

License:

Rating:

FAI:

Mobile No: *

Residential Address: *

E-mail address: *

Sex: *
MaleFemaleOther

Shirt size: *
SMLXLXXLXXXL

Accommodation preference (I opted for):
ChaletsCamping

Blood type: *

Food preference:
No PrefHalaalVeganOther
If other:

Medical Aid:

Medical Aid Number:

Emergency Contact Name: *

Emergency Contact Number: *

Fly-In Fee Paid: *
YesNo

Notes:
(Anything to clarify the above. Please mention here if you are part of a party with more than one pilot and who you will be sharing if that is the case. Enter anything here you may wish to bring to our attention)

* Indicates required field

Δ