Crickhowell Paragliding Booking Form

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This form This form must be completed by every person who would like to train or partake in a tandem paraglider flight with Crickhowell Paragliding. The data collected is only for our own use only and will not be passed on or sold. All data is securely stored and disposed of properly when your flight, or training course is completed.

Email *

Your Full Name *

Your Email Address *

Please enter the product number

Mobile Phone Number *

Please enter the product number

Age *

If under 18 you require parental consent

Weight *

Your weight in kilograms when wearing outdoor clothing.

Name of person who purchased this for me (if Gifted with payment reference). If not a gift please write N/A

Previous Experience with paragliding or other aviation activities

Any previous paragliding or aviation qualifications or general outdoor activity experience. We will require copies of any previous BHPA training or Log books

Previous Paragliding Qualifications

Any previous paragliding or aviation qualifications or general outdoor activity experience. We will require copies of any previous BHPA training or Log books

BHPA Elementary Pilot Course

BHPA Club Pilot Course

BHPA Pilot Rating

IPPI Para Pro

Other Non UK Paragliding Qualification

Other:

Clear selection

Medical, Health and Fitness *

If the answer to any of these is NO, then you may not be able to start a course with us. If you are on a tandem flight and you have said no to a, e, or f, it may still be possible, but you must discuss this with us first. This is for your own safety. If you cannot see the buttons, rotate the phone!

Yes

Are you able to run a short distance (approx 10m)

Are you able to sustain a fall onto grass from a run without injury?

Are you able to sustain a feet first impact equivalent to jumping from a chair?

Are you fit enough to complete a day of moderate hill walking?

Are you able to see well enough to drive a car, with or without glasses or lenses? only applicable if learning to fly, not for required for tandem flights.

Yes

Are you able to run a short distance (approx 10m)

Are you able to sustain a fall onto grass from a run without injury?

Are you able to sustain a feet first impact equivalent to jumping from a chair?

Are you fit enough to complete a day of moderate hill walking?

Are you able to see well enough to drive a car, with or without glasses or lenses? only applicable if learning to fly, not for required for tandem flights.

Do you or have you ever suffered from any of the following; *

Yes

Heart disease (including angina) or any other heart condition?

Circulatory problems including high blood pressure?

Epilepsy?

Diabetes?

Severe vertigo or dizziness?

Increased susceptibility to bone breakage or joint dislocation?

Severe skeletal damage with increased risk of injury?

Asthma or other respiratory conditions?

Any Condition/Medication/Operation/Treatment which may affect your ability to participate?

Yes

Heart disease (including angina) or any other heart condition?

Circulatory problems including high blood pressure?

Epilepsy?

Diabetes?

Severe vertigo or dizziness?

Increased susceptibility to bone breakage or joint dislocation?

Severe skeletal damage with increased risk of injury?

Asthma or other respiratory conditions?

Any Condition/Medication/Operation/Treatment which may affect your ability to participate?

If the answer to any of the above is YES, or you are unsure please give any history and details below

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