A USHPA National Championship Series event June 13-20, 2020

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Application form

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Pilot's Application Form

Event you wish to enter:*

Open Race

Sprint Race

Super Clinic

First Name*

Last Name*

Sponsor

If you have one...

USHPA number*

Foreign pilots who do not have a USHPA number enter 99999

FAI number

Enter your FAI number if you have one. You must have a valid FAI sporting license at the time of the comp to receive WPRS points in the Race. Apply now if yours is not current (must be renewed yearly).

CIVL ID

Enter your CIVL ID if you have one.

Birthdate*

Sex*

Male

Female

T-shirt selection*

Men's small

Men's medium

Men's large

Men's Xtra large

Men's 2xtra large

Men's 3xtra Large

Woman's small

Woman's medium

Woman's large

Woman's Xtra large

Street*

City*

State*

Zipcode*

Country *

Enter your country abbreviation

Email address*

Confirm Email address*

Cell phone number*

Satellite tracker you use*

SPOT

INReach

Satellite tracking URL*

Paragliding Experience in wing you are flying

Paragliding rating*

P3 minimum required for Open and Sprint races. P2 minimum required for SuperClinic

Hours flown*

Total hours flown in Paragliders

Number of flights*

Glider you will be flying in the event

Glider Manufacturer*

Glider model*

Glider rating*

EN A

EN B

EN C

EN D

CCC

EN rating for your wing. ONLY CERTIFIED GLIDERS ARE ALLOWED. EN A rated gliders are not allowed in the Open Race. EN D and CCC rated gliders are not allowed in the Sprint Race.

Glider size*

Glider color*

Emergency Contact Information

Emergency contact name*

Emergency contact relationship*

Emergency contact phone number*

Medical info:

Blood type*

Alergies*

If NONE please state "NONE"

Medical Insurance provider*

Insurance ID number*

Group ID number*

Insurance provider's phone number*

Policy holder's name and phone number*

Added questions for Super Clinic applicants

Weight*

lbs.

Where are you in glider's weight range*

Bottom, middle, top?

Other medical info*

Any medical information instructors need to know

Date of last reserve repack*

Equipment you fly with*

Harness, Radio model, GPS, Vario

What Launch Technique do you use?*

A's and brakes, A's and D's, Etc...

Have you ever attended a maneuvers clinic?*

If so, when and who with?

What's the largest deflation you have experienced?*

percent

Current?

How many hours have you flown in the last year?

Total hours thermic, total hours flying XC, and longest XC distance to date.*

What is your home site and what sites have you flown?*

Have you flown Woodrat Before?*

Briefly describe your goals in attending the SuperClinic?*

What do you want to learn? What skills do you want to improve?

Agreement to terms:

I have a current USHPA membership or will have one when flying in the event. I also agree to to comply with the Local RVHPA club rules and the Applegate Open competition local rules.

Agree

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