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Cumulux - New member

Membership category *

Full member Cumulux Paragliding Club (one-time-fee: 40€, yearly membership fee: 60€)

Non-flying member (one-time-fee: 40€, yearly membership fee: 10€)

Note: The yearly fee should be paid for the period from January, 1st until September 1st. If you join afterwards the yearly fee will be valid already for the next year.

Personal information

Name *

First name *

Username *

Birthplace *

Birthday *

 . .  (DD-MM-YYYY)

Address *



Phone number (private)

Phone number (mobile)

Phone number (office)

E-mail address *

Blood type (+ rhesus factor)


Flight licence

Do you have a flight licence *

Yes       No

Issuing country

Category

Licence number


Flight federation

Member of a federation

Yes       No

Federation name

Federation licence number


Person to contact in case of emergency

Name

First name

Address



Phone number (private)

Phone number (mobile)


Anti-SPAM *

What is 3 plus 4? *


Important: A copy of the message with further instructions will be sent to your given e-mail address!

* required