International Vintage Sailplane Meet Online Registration Form

There were errors on the form, please make sure all fields are filled out correctly (see below).

Registrant

   
First Name Last Name
Address Address 2
City State Postal
Nationality Country    
Phone Phone 2
Email 1 Email 2
Certification

Emergency Contact

   
First Name Last Name
Phone Phone 2
Relationship Email

Memberships

   
Member of Soaring Society of America? Yes   No
Member of VSA? Yes   No
Member of NSM? Yes   No

Crew Information

   
Number of Crew  

Sailplane Information

   
Manufacturer Model
Year Number of Seats
Registration # Are you the owner Yes   No
Insurance Carrier Policy #

Camping Information

   
Number of Campsites    
Number of Campers    

Payment

   
Pilot @ $100.00 ea.
Secondary Pilot @ $40.00 ea.
Crew/Non-Flying @ $40.00 ea.
  Total Payment: $

Card Number Expiration (MM/YYYY) /    
Card Holder Name CVC Is your payment secure?
There were errors on the form, please make sure all fields are filled out correctly (see above).