Preferred Pilot Number _________ FAI Number
________ Category SE/SP/O/I/N _________
Name: _______________________ First Name ___________________ License #_______________
Club: _____________________ License Grade: ___________________ Glider
Type:_____________
T-Shirt Size? XS, S, M, L, XL, 2XL. etc.. Extras ? (Number / size) _________________(R.. each)
Accommodation Required? Give details_________________________________________________
Full Postal Address__________________________________________________________________
____________________________________________________Country_______________________
Tel: (h): (w): (mobile): (fax):
Next-of kin: ____________________________________ (Relationship)_____________
Their Contact Details: _____________________________________________________
Blood Group: __________ Medic Alert? ___________ Details ________________________________
Allergies, or other important Medical Information: __________________________________________
Medical Insurance Details (SportsCover…etc.)______________________
Entry Fee R...
Bank: XXXX Bank
Contact Person: XYZ
Name: XYZ Competitions
Mobile: +27 21 ....
Branch: zzzzzzzz
Fax: +27 21.......
Cape Town
Account: 112 34 56
Accommodation: uytre
Branch code: 33 44 55
Tel: +27 22 ..............
SWIFT Code: XXXXXXX
Fax: +27 21 ...........