Registration Form

So that we can plan for your training, please complete this online form soon to book your appointment.

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* Required information.
First & Last Name *
Street *
City, State, Zip *
Date of Birth *
Gender *
Male
Female
Weight (lbs) *
Phone *
Email
Emergency Contact
Are you currently a member of
USHGA
USPPA
Select One
Check Class Requested : 2 Lessons (1 day) $200
P2 or PPG 2 : 10 Lessons $1,000
Tandem flight $99.00
Day 1
Day 2
Day 3
Previous Aviation Sports Experience *
Do you have a medical condition that could affect your training? *
Yes
No
If Yes, please elaborate
Do you have a significant medical history (knee and ankle injuries, dislocated shoulder, heart problems, etc.)? *
Yes
No
If Yes, please elaborate

I am aware that Paragliding can be hazardous. Mojo's Flight School/Southern Skies notified me that they do not carry liability or any other insurance. I will be responsible for myslef if I injure myself during my paragliding activities.

Date *

I have read, understand and certify that all information is correct in my Registration Form and that I AGREE with the above statements in their entirety.

Type your name here to certify this document, then press SUBMIT. *
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