GENERAL DISPLAY PILOT REGISTRATION 7 Australian AirDisplays General Display Pilot Registration Thanks for taking the time to complete our electronic Display Pilot Registration Form. The information provided in this application forms part of the Airshow Approval process and is forwarded to the Civil Aviation Safety Authority (CASA) IAW the Australian Airdisplays Pty Ltd (AA) Exposition. Completion of the registration process is straight forward PROVIDED you have electronic (PDF) copies of the following documents ready for up-load BEFORE commencing the form : Air Display Approval/ Instrument, Proposed Display Sequence, Pilots Licence, Medical Certificate, Aircraft Certificate of Airworthiness, Aircraft Noise Certificate, and Aircraft Insurance Coverage (Refer Note Below). If you intend to conduct Commercial or Aerial Work activities at the Airshow (eg Joy Flights, Banner Towing, TIF's, Adventure Flights etc), you will be require to up-load copies of your CASA AOC and other Approval Documents. NOTE : AA requires all Display Aircraft carry hull loss insurance as well as a minimum of $5,000,000 in public liability coverage, listing Australian AIrdisplays Pty Ltd as an "Interested Party". Our WEB and Forms are best viewed using Chrome, Safari, Firefox, and Explorer. YOUR DETAILS Please provide your contact details.Name* First Middle Last Address* Street Address City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mobile Phone*Email* HISTORY & EXPERIENCE"your aviation background and experience"Professional History*Please select those items which best describe your flying experience and history Airline Military Charter Instructor Aerial Display Aerial Work Other If other, please list below:*Please provide a brief written summary of your flying experience. Be sure to cover the items you selected above.*Total Flight Hours*Total Command Hours*PILOT LICENCING"your licences and approvals"Pilots Licence (Type)*Please select the types of Pilots Licenses you hold: RPL (A) PPL (A) CPL (A) ATPL (A) RPL (H) PPL (H) CPL (H) ATPL (H) Other If other, please list below:*Pilots Licence (ARN)*What is your Aircrew Reference Number (ARN)?Are you subject to annual licence Proficiency Checks/ Flight Reviews under an approved Part 141/ 142 training and checking organisation?*YesNoWith which organisation?*Biennial Flight Review (BFR)*When is your BFR due for renewal. Date Format: DD slash MM slash YYYY Do you hold an Aerobatic Endorsement / Licence?*YesNoAerobatics/ Low Level Aerobatic Limit (AERO/ LLAERO)*Please select your lowest approved Aerobatic altitude limit.A300 - Aerobatics > 3000 ftA150 - Aerobatics > 1500 ftA100 - Aerobatics > 1000 ftA050 - Aerobatics > 500 ftAULT - Aerobatics unlimitedOther Aerobatic AltIf other AERO/ LLAERO altitude limit*Please annotate your Low Level Aerobatic altitude limit.When did you last conduct Aerobatics* Date Format: DD slash MM slash YYYY Do you hold a Formation Endorsement / Licence?*YesNoWhen did you last participate in formation flying?* Date Format: DD slash MM slash YYYY Do you hold a Formation Aerobatic Endorsement / Licence?*YesNoForm/ Low Level Form Aeros (FAERO/ LLFAERO)*Please select your lowest approved Formation Aerobatic altitude limit.A300 - Form Aeros > 3000 ftA150 - Form Aeros > 1500 ftA100 - Form Aeros > 1000 ftA050 - Form Aeros > 500 ftAULT - Form Aeros unlimitedOther Form Aeros Alt LimitIf other FAERO/ LLFAERO altitude limit*Please annotate your approved Formation Aerobatics altitude limit.When did you last conduct Formation Aerobatics* Date Format: DD slash MM slash YYYY Please attach an PDF copy of your Part 61 Pilots Licence.*Please upload all pages of your licence, ensuring your name, licence number, and any expiry date or limit is clearly displayed. (Max File Size 5MB) Drop files here or DISPLAY APPROVAL/ INSTRUMENT'your CASA Display Approval and Display Sequence"Do you hold a current Display Approval?*YesNoDisplay Approval/ Instrument Number*Please list your Display Approval/ Instrument Number here.Expiry Date*Please list your Display Approval/ Instrument Expiry Date here. Date Format: DD slash MM slash YYYY Please attach a PDF copy of your Air Display Approval/ Instrument & Proposed Display Sequence. (Max File Size 5MB).* Drop files here or CASA FORM 697 REQUIRED To be part of a Flying Display you will need to complete a CASA Form 697 and send it to CASA for a Display Approval/ Instrument. Please continue to complete this form. Details on completing a CASA Form 697 will automatically email to you after submission of this form.COMMERCIAL FLIGHT OPERATIONS'Charter, Aerial Work, Flight School or Adventure Flight Activities'Will you be conducting any Commercial Flights at the Airshow?*Joy Flights, Banner Towing, Trial Instructional Flights, or Adventure Flights.YesNoWhat is the Company or Business name conducting the commercial flights?*CASA Approval/ Instrument Number*Please list your CASA AOC Approval/ Instrument or Other Approval No here.Expiry DatePlease list your AOC Approval/ Instrument or other approval type expiry date here. If perpetual leave blank. Date Format: DD slash MM slash YYYY Please attach a PDF copy of your CASA AOC Approval/ Instrument or Other Approval document. (Max File Size 5MB).* Drop files here or MEDICAL LICENCE"feelin and being fit'What class of Medical Licence do you hold?*Please list your 'highest' Medical Class Licence you hold.Class 1 MedicalClass 2 MedicalOtherMedical Licence Expiry*Please list when your Class 2 Medical Licence is due for renewal. Date Format: DD slash MM slash YYYY If other type of Medical Licence:*Please explain your type of Medical Clearance to fly aircraft.Medical Expirey*Please enter your medical expiry date or Nil if not applicable.Please attach an PDF copy of your Aviation Medical Licence.*Please upload all pages of your Medical licence, ensuring your name, licence number, and any expiry date or limit is clearly displayed. (Max File Size 5MB). Drop files here or DISPLAY AIRCRAFT DETAILS"what you will be flying at the airshow"Aircraft types you will be flying at the Airshow.*Please list the aircraft types, registration, and number of hours you have on each type, below:Aircraft TypeRegistrationHours on Type Date of Arrival:*What date do you intend on arriving for the proposed Display? To ensure proper rest, Display pilots are encouraged to fly-in the day before their Airshow. Note that the Australian Airdisplays Pty Ltd (AA) Air-Boss may require you to conduct a practise and or proving display flight on a day before the proposed Airshow day. If no date is currently planned please select any date. Date Format: DD slash MM slash YYYY Certificate of Airworthiness*Please attach a PDF copy of your Certificate of Airworthiness (including all annexures) for each aircraft you will operate. (Max File Size 5MB). Drop files here or NOISE CERTIFICATE'keepin it neighbourly'Does your aircraft type require a Noise Certificate Exemption under CASA regulations? (Warbirds select 'Yes').*YesNoPlease select*I have a Noise CertificateI don’t have a Noise CertificateExemption Number*Located at the top of your Noise Exemption letter.Expiry Date (if any) Date Format: DD slash MM slash YYYY Please attach a PDF copy of the Noise Certificate for each of your aircraft.*Please ensure the Exemption Number and expiration date (if any) are clearly visible for each aircraft. (Max File Size 5MB). Drop files here or NOISE CERTICATE REQUIRED Warbirds and historical aircraft need a Noise Certificates to operate. If you do not have a current Noise Certificate, please continue to complete this form. Details on how to obtain a noise certificate will automatically email to you after submission of this form.AIRCRAFT & PUBLIC LIABILITY INSURANCE"keeping us all insured"Please attach a PDF copy of your Aircraft Insurance / Public Liability coverage for each aircraft.*AA requires all Display Aircraft carry hull loss insurance as well as a minimum of $5,000,000 in public liability coverage, listing Australian AIrdisplays Pty Ltd as an "Interested Party". Please also ensure that the policy expiration date and aircraft registration is clearly visible for each aircraft. (Max File Size 5MB) Drop files here or EMERGENCY CONTACT Please provide details for the person you would like notified in the event of an emergency.Emergency Contact Name* First Last Emergency Contact Mobile Phone:*Emergency Contact Email Address:* Emergency Contact Address* Street Address City State / Province / Region Post Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country TERMS AND CONDITIONS Your participation in an Australian Airdisplays Pty Ltd Airshow is conditional upon our Terms and Conditions.AUSTRALIAN AIRDISPLAYS PTY LTD AIRCREW TERMS AND CONDITIONS Fullscreen ModeDo you agree to these terms and conditions?*YesNoThanks ! 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