Your Name (required)

HGFA Number (required) EXP Date

CIVL

Are you Aerotow Endorsed? YesNo

Have you ever aerotowed at Dalby before? yesno
if so, what year/s

Phone Number (required)

Mobile Phone (required)

Your Email (required)

Date of Birth

Payment Type —Please choose an option—Pay Pal/Credit CardDirect Deposit

Meal Option (required) —Please choose an option—vegetarian mealnon-vegetarian meal

T-Shirt Size (required) —Please choose an option—SMLXLXXL

Glider Make —Please choose an option—MoyesWills WingAerosAirborne Other:

Glider Model

Glider Size

Glider Colours

Glider Class

Emergency Contact:

Name

Email

Phone Number

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