Aircraft Permit Request

Aircraft Permit Request

Please provide your details and drone information to request a permit.
Date

MonthDayYear
Date
Full Name of Requestor (must be over 18)

First NameLast Name
Name(s) of Aircraft Operator(s) - If Different than Requestor
Home Address of Operator

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date(s) you are Requesting to Operate
Time of Day
Park Location
Aircraft Type

Other
Aircraft Make/Manufacturer
Aircraft Model #
Is the Operator a Licensed Aircraft Operator?
Please Provide Details of License and License #
What is the Purpose of Flying your Device on Huntley Park District Property?
Unmanned Aircraft Systems (Drone) Waiver and Release

Warning of Risk

Unmanned aircraft systems (UAS) flying involves a test of a person’s physical and mental capabilities and carries with it the potential for death, serious injury, and property loss. Certain risks include burns from fires, electrical shock and electrocution, being struck by a UAS flown by myself or other hobbyists, failing to follow manufacturers’ recommendations, inadequate or defective equipment, inadequate supervision or instruction, and all other risks inherent to UAS flying. In this regard, it is impossible for the Huntley Park District to guarantee absolute safety.

Waiver and Release of All Claims and Assumption of Risk

Please read this language carefully and be aware that in consideration for participating in this activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this activity (including transportation services, when provided).

I recognize and acknowledge that there are certain risks of physical injury to participants in this activity, and I voluntarily agree to assume the full risk of any and all injuries, damages or loss, regardless of severity, that my minor child/ward or I may sustain as a result of said participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this activity against the Huntley Park District, including its officials, agents, volunteers and employees.

I agree to indemnify and hold harmless the Huntley Park District against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf (or on behalf of my minor child/ward), including reasonable attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else action on my behalf (or behalf of my minor child/ward).

By signing below, I have read and fully understand the above warning of risk, assumption of risk and waiver and release of all claims. If registering on-line or via fax, my on-line or facsimile signature shall substitute for and have the same legal effect as an original form signature.
Applicant Name

First NameLast Name
Date

MonthDayYear
Date
Applicant Signature
PLEASE ALLOW 7-10 BUSINESS DAYS FOR A RESPONSE TO THIS REQUEST.
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