International Soaring Centre Narromine
TEL OFFICE +61-2-68891856 Soar Narromine Pty Ltd
TEL AH +61-2-68892537 PO Box 56, Narromine
Mobile (041) 999 2396 NSW 2821 Australia
Website
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; A$ Bank Cheque; Credit Card Telephone Order [ Mastercard Visa Amex] (Add 3.0% for credit card charges).
Date of Payment ...... or Details of Credit Card: Credit Card Holder, Credit Card Number and
Credit Card[Mastercard, Visa, Amex]カード番号………………………………………有効期限…………… 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;