Cumulux - New member

Membership category *

Full member Cumulux Paragliding Club (one-time-fee: 40€, yearly membership fee: 60€)

Non-flying member (yearly membership fee 10€)

Note: The yearly fee should be paid for the period from January, 1st until September 1st. If you join afterwards the yearly fee will be valid already for the next year.

Personal information

Name *
First name *
Username *
Birthplace *
Birthday *	. . (DD-MM-YYYY)
Address *
Phone number (private)
Phone number (mobile)
Phone number (office)
E-mail address *
Blood type (+ rhesus factor)

Flight licence

Do you have a flight licence *	Yes No
Issuing country
Category
Licence number

Flight federation

Member of a federation	Yes No
Federation name
Federation licence number

Person to contact in case of emergency

Name
First name
Address
Phone number (private)
Phone number (mobile)

Anti-SPAM *

What is 3 plus 4? *

Important: A copy of the message with further instructions will be sent to your given e-mail address!

* required