Paradise Air Safaris

Questionnaire and Disclaimer (revised 17/1/09)

To assist in our planning including arranging PNG flight approval and customs clearance, I would appreciate that each member completes the following questionnaire and returns it to myself ASAP.

Questions 7 – 16 apply to pilots only.

             Name as it appears on passport: 

Personal:

1.        How did you find out about this tour?

2.        What size Safari shirt do you require?

3.        Person to notify in case of emergency:

        Name:

        Address:

        Phone:

        Relationship:

4.        Passport Number:                                   Place of issue:

5.        Special medication or physical constraint:

Aircraft (pilots to complete):        

6.        How many spare seats are you able to offer? 

7.        Are you IFR or VFR?

8.        Approx. number of hours.

9.        Are you HF radio equipped? (Check with co-ordinator about the frequencies required-they change without notice)

                        Aircraft Details required by PNG Civil Aviation:

10.     Type & Model:

11.     Endurance:

12.     Registration No:

13.     All Up Weight (kg):

14.     Tyre Pressure (kpa)

15.     Safety Equipment Carried: Life Jackets  Life Raft  First Aid    Water  Fire Ext.  VHF 

          GPS   ELT: 121.5  243  406 fixed portable other

Disclaimer

1.      Being a participant in the Air Safari (or on such date as my final return to my usual place of residence) acknowledge as follows:

2.      The Coordinator, Paradise Air Safaris Pty Ltd is acting in the capacity of agent for me in relation to all arrangements made for my participation in the Air Safari.

3.      There are inherent risks in flying and in particular flying in Papua New Guinea & over vast amounts of water.

4.      There are risks in relation to personal safety and the safe keeping of the aircraft whilst on the ground due to political, economic and social factors present at this time in Papua New Guinea.

5.      I will not hold Bill Finlen and/or Paradise Air Safaris Pty Ltd and/or any or all of its staff or assistants, including Bob Bates and Trans Niugini Tours, their servants, agents or contractors liable in the event of any loss or damage or personal injury occasioned to my property or my person whilst participating in the Air Safari.

6.      I have read the notes provided and consider that I have the experience and currency to undertake the Safari in both a legal and practical sense.

7.      I indemnify and agree to keep indemnified Bill Finlen and/or Paradise Air Safaris Pty Ltd and/or any or all of its staff or assistants, including Bob Bates and Trans Niugini Tours, their servants, agents or contractors from and against all loss, damage, expense or claims that may be incurred or occasioned by them as a consequence of an act, neglect or default on my part (including, without limitation, a failure on my part to personally attend to the matters set out in paragraph 6).

8.      I have been advised of the desirability to take out appropriate personal and medical insurance to cover without limitation, the cost of evacuation if required together with appropriate hull & liability cover in all of the areas I am flying.

9.      As pilot in command, I understand and accept full responsibility for:

a.       the safe operation of my aircraft;

b.      preparing and submitting all flight plans;

c.       obtaining, verifying and interpreting all meteorological reports and data;

d.      compliance with all operating laws and standards of the places visited;

e.       the need to obtain separate and/or additional insurance cover for the places visited;

f.        verifying the currency & suitability of any charts, maps & airfield data provided by the Coordinator.

10.  Item 8 is for Pilots/captains only, however passengers and crew would be wise to discuss these issues with their captains.

Signed:………………………………………….. Dated:……………