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Scottish Gliding Centre - Application for 5-Day Gliding Course
Please print out, complete and send with cheque to address on the contact page

To: The Scottish Gliding Centre, Portmoak Airfield, Scotlandwell, near Kinross, KY13 9JJ

Applicant
Full Name ___________________________________ Date of Birth ________________

Address _______________________________________________________________

______________________________________________________________________

______________________________________________Post Code________________

Telephone Number__________________

Next of Kin

Full Name ___________________________________ Relationship ________________

Address _______________________________________________________________

______________________________________________________________________

______________________________________________Post Code________________

Telephone Number__________________

I wish to apply for course number ________ year _________

Residential _____ Non Residential _____ (Please tick)

I agree to be bound by the rules, byelaws and gliding regulations of the Scottish Gliding Centre as detailed in the Site
Briefing Notes and elsewhere.

Previous flying experience.

Gliding hours ______ Gliding hours ______ Badges ______________________ Power hours ______
(total) (solo)

Medical Declaration

I declare that:
1. To the best of my knowledge I have never suffered from any of the following conditions which may create or lead to a
dangerous situation in flight: epilepsy, fits, severe head injury, recurrent fainting, giddiness or blackouts, unusually high
blood pressure, coronary heart disease.

2. In the event of my contracting or suspecting any of the above conditions or any other physical or mental condition
which might be a result of my being a danger to myself or others whilst flying a glider, I will cease to fly until I have
obtained medical opinion and authority to resume flying.

Notes: The following conditions may cause difficulty while flying: chronic bronchitis, severe asthma, rheumatic fever,
chronic sinus or ear disease, diabetes, kidney stones, severe travel or motion sickness, severe migraine, any psychiatric
condition. If you suffer, or have suffered any of these conditions you are advised to take medical opinion before flying.
The following will probably make you temporarily unfit to fly: minor illnesses including head colds, medication, and
donation of blood. If you normally wear spectacles you must always carry a readily accessible spare pair whilst flying.

Signature of Applicant:
Signed ______________________________ Dated _____________________

Signature of parent or guardian if applicant is under 18 years of age:

Signed ______________________________ Dated _____________________
Name _______________________________
Address _____________________________

____________________________________

Witnessed by:

Name _______________________________ Name _______________________________
Address _____________________________

____________________________________

 Address _____________________________

____________________________________

I enclose a deposit of £50. A further payment of £330 (non-residential ) or £465 (residential) is payable on registration for the first day of the course. This will cover the remainder of the course fee and a nominal £200 worth of flying fees. Any shortfall (or excess) payment will be payable (or refunded) within one month of the end of the course.

page last updated on 22nd July 2008
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