Alpine Helicopters Client Liability Waiver + Safety Briefing

1

Booking Reference:* This field is required.example: company, lead guest or date of flight

2

Name

First Name

Last Name

3

Email* This field is required.

example@example.com

4

Phone Number* This field is required.

5

Weight - Kg* This field is required.weight in kg

6

Additional gear and weightE.g Camera gear, Cakes/wedding equipment

7

Date of Travel* This field is required.

Date

8

Emergency Contact Name* This field is required.This contact must not be on your flight

First Name

Last Name

9

Emergency Contact Phone Number* This field is required.Please include a country code if this contact is outside New Zealand

10

Alpine Helicopters Aircraft Safety BriefingPlease watch the full duration of the safety briefing video prior to arrival

11

Dangerous Goods

12

Are you carrying dangerous goods?* This field is required.Dangerous goods are articles or substances that are capable of posing a significant risk to health, safety, or property when carried by air. If you are unsure if your items are considered to be a dangerous good please ask one of our team members. Some of these items may include but are not limited to: Installed or spare lithium batteries with ratings more than 160Wh or 8g lithium content, More than one box of matches or lighter, Liquid oxygen systems, Disabling devices containing an irritant or incapacitating substance such as pepper spray, Electric shock weapons containing dangerous goods such as explosives, compressed gas or lithium batteries, aerosols that are not medicinal or toiletry items.

YESNO

13

Dangerous GoodsIf you answered yes to the previous question, please provide further detail of the goods carried.

14

I acknowledge I have watched the full duration of the safety briefing video. I acknowledge that I understand the safety terms & briefing. Further, I hereby assume all risks and release all persons, entities or contractors connected with Alpine Helicopters from all liability for any injury or damages and from any claim by me, my family, estate, agents, heirs or assigns arising in any way from participation in all, and any activities connected with Alpine Helicopters.* This field is required.Please sign below

Clear