Cloudbase Therapy Paragliding Academy

Registration type (mark all that apply) *This question is required.

Student-pilot
Volunteer

Answering as *This question is required.

Parent / Legal guardian #1 FIRST name *This question is required.

Parent / Legal guardian #1 LAST name *This question is required.

Parent / Legal guardian #2 FIRST name

Parent / Legal guardian #2 LAST name

Student-pilot / Volunteer FIRST name *This question is required.

Student-pilot / Volunteer LAST name *This question is required.

Date of birth *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Sex *This question is required.

Street address *This question is required.

Apt/Suite/Office

City *This question is required.

State *This question is required.

Zip *This question is required.

Email Address *This question is required. This question requires a valid email address.

Telephone number

Mobile number *This question is required.

Weight *This question is required.

Height *This question is required.

Ethnicity (check all that apply)

Caucasian
African American / Black

Hispanic/Latino
Asian

Middle eastern
Native American / Alaskan

Pacific Islander
Other

Are you a certified paraglider pilot? *This question is required.

What is your USHPA membership number? *This question is required. This question requires a valid number format.

Which Special Skills are you certified in? *This question is required.

Foot Launch (FL)
Ridge Soaring (RS)

Cliff Launch (CL)
Turbulence (TUR)

Surface Tow (ST)
Flat Slope Launch (FSL)

Restricted Landing Field (RLF)
High Altitude (HA)

Para-Ski (PS)
Cross-Country (XC)

What skills or talents would you like to contribute to the Project? We would love to make the best use of your natural gifts, so please feel free to write as much as you would like. *This question is required.

How did you learn about us?

Friend
Google

Television
Youtube

Newspaper
Saw people practicing

Cloudbase Therapy Paragliding Academy

Registration Form