Pilot and Aircraft Profile Liability Waiver
Check One: ( ) Initial Application
(
) Updating Information
Attention: By submitting this form, you accept responsibility for ensuring you are in compliance with all Federal
Aviation Regulations including but not limited to flight currency, required licensing, pilot health, and aircraft
registration and airworthiness. A copy of your Aircraft Owner/Renter Liability Insurance must be on file with
Flying Paws. Please sign the second page and return all documentation to Flying Paws as instructed at the end of
this document. Thank you for being a Flying Paws volunteer.
Pilot Name: _______________________________________
Phone #1 _____________
Street Address: ____________________________________
Fax: _____________
City, State, Zip: ____________________________________
Cell Phone: ___________
____________________________________
Email: __________________
Emergency Contact: _________________________________
Phone Number: _________
Relation: ______________________________
Ratings: ___________________________________________
Availability: (Circle One): Weekday Weekends
Distance Willing To Fly: (Circle the Greatest) Less than 300 nm,
300-500nm ,Greater than 500nm
Airport Restrictions: (Circle) Paved Runway, Runway longer than 5,000 ft,
Controlled, Airport Elevation Less Than 5, 000 ft,
Other: ___________________________________
Aircraft #1
Aircraft #2
Tail Number: __________________________
Aircraft Type/Model: ____________________
Color: ________________________________
Airport Based At: _______________________
Identifier: _______________________
FBO Name: ____________________________
Contact: _________________________
Phone Number: ___________________
Circle One: Rent or Own
Cruise Speed: (Circle One) Under 100nm/hr,
100-150nm/hr, 150- 200nm/hr
Over 200nm/hr
Pressurized: Yes or No
Fuel Capacity: ______________________
Burn/Hr Cruise: _______________
Tail Number: ____________________________
Aircraft Type/Model: ______________________
Color: ___________________________________
Airport Based At: _________________________
Identifier: _________________________
FBO Name: ______________________________
Contact: ___________________________
Phone Number: _____________________
Circle One: Rent or Own
Cruise Speed: (Circle One) Under 100nm/hr,
100-150nm/hr, 150-200nm/hr,
Over 200nm/hr
Pressurized: Yes or No
Fuel Capacity: _______________________
Burn/Hr Cruise: ________________
Page 1 of 2
Page 2 of Pilot and Aircraft Profile Liability Waiver
Total Useful Load: _____________________
Useful Load Rescue Weight: ________
Total Useful Load: ______________________
Useful Load Rescue Weight: ________
Additional Information: ________________________________________________________________
Liability Waiver for Pilot Volunteers
Flying Paws is an all volunteer organization. Flying Paws pilots, flight crews and ground crews
voluntarily provide free air transportation in privately owned or rented aircraft for special needs rescue
animals. Flying Paws does not financially reimburse the pilots, flight crews or ground crews for any
expenses for these flights. Ground crews provide help with promotions, educational programs and
emergency ground transportation for veterinary care of the animals in transit. No personal expenses
are reimbursed.
I, the undersigned Flying Paws volunteer, agree to waive and do waive and release Flying Paws, its
officers, directors and other volunteers from any and all claims including, but not limited to liability for
negligence, any personal injury or property damage that might be suffered, and any wrongful death
actions which an estate might bring, arising out of injury during any Flying Paws flight or activity. It is
understood and acknowledged that my signing this Waiver of Liability is bound and effective for any and
all Flying Paws flights or activities. I further understand that the pilot in command (PIC) of any Flying
Paws flight has the final decision concerning the cancellation of the flight due to weather, mechanical
problems or for any reason whatsoever, if in their judgment the flight can not be completed in a safe
manner. Flying Paws requires that the pilot of any VFR or IFR flight be current, hold the correct
certificate, maintain currency, medical certificate and meet all of the FAA regulations required for that
flight. The aircraft must meet all requirements for the flight undertaken. The PIC has the option to have
a non-pilot or another pilot to fly with them provided that they have signed the Liability Waiver and it is
on file with Flying Paws. The providing of any transport is totally voluntary and if there is any reason
whatsoever that the flight can not be completed in a safe manner: the flight is to be cancelled or
postponed. I understand that the animals must be transported in appropriate kennels and must be
accompanied by all required paperwork. Kennels are provided by the pilot due to the different
configurations of the aircraft and remain the property of the pilot. Should an animal be transported
outside of a kennel, it is the PIC who will determine whether the flight will happen. Flight safety
determines any and decisions by the PIC.
Signature: ____________________________________________________
______________
Printed Name: _________________________________________________
Please email completed form and a scan of your insurance policy to pilots@
documents to Flying Paws P.O. Box 4798 Chino Valley, AZ 86323
Page 2 of 2
Date:
. OR, mail these