NZHGPA AIRS_Witness Report

NZHGPA AIRS_Witness Report

(REV 1.0 01/05/25)
How this form works
This form may be saved, continued at a later time, and then submitted when completed. Press SAVE, to save your entries. You will be automatically sent a link to the email you provide, then use the link to continue your reporting, and press SUBMIT REPORT when completed.

If you have any changes after you have submitted, please contact safety@nzhgpa.org.nz.

Information provided will be held in confidence and used by the Operations Team for improving safety within the NZHGPA 149 Certification.

The personnel reporting, and the NZHGPA Safety Officer, will automatically receive a PDF copy of their application.

This form is a controlled document, managed by the NZHGPA, under the delegation of the Civil Aviation Authority (CAA).
Report Instructions
1. This form is to be filled out for NZHGPA Airs Record Keeping;
2. Complete all areas where applicable; be specific in details;
3. Files/photos/illustrations can also be uploaded; max 5MB.
Witness Details

All personal information remains CONFIDENTIAL.
Date of Report*

DayMonthYear
Date
Witness Name*

First NameLast Name
Witness Phone Number*

Area CodePhone Number
Witness Email*
example@example.com
Are you a...?*

NZHGPA StudentNZHGPA MemberNZHGPA InstructorMember of the public (not a pilot)
Were there any other witnesses present?*

YESNO
If known, please add their names and contact details below:
Occurrence Details

SPECIFY Details
Pilot Name*

First NameLast Name
Occurrence Location - Site Name and nearest town or GPS Coordinates*

SITE NAME or GPS CoordinatesNEAREST TOWN or GPS Coordinates
Occurrence Date/Time*

DayMonthYear
Date
Hour MinutesAM/PM Option
Aircraft Type*

ParagliderHang GliderSpeed WingPowered ParagliderPowered Hang Glider
Occurrence Type*

Near Miss (no damage to glider, no injury)Minor Incident/Accident ( minor injury or minor damage to glider/equipment)Serious Incident/Accident (serious injury or serious damage to glider/equipment)Fatal Injury
Emergency Services on site:*

NoneMedevac (helicopter)AmbulancePoliceOther
Region where occurrence happened*

NorthlandAucklandWaikatoBay of PlentyHawkes BayTaranakiManawatuWellingtonMarlboroughTasmanCanterbury and West CoastAorangiSouthernOverseas
Specify the details of what you witnessed:*
Other Notes/Comments
File upload

ADD ANY FILES/PHOTOS/ILLUSTRATIONS; MAX 5MB
Cancelof
Should be Empty:

NZHGPA AIRS_Witness Report

How this form works

Report Instructions

Witness Details

Occurrence Details