Aviation Participation Form

Check All That Apply *

I am an aircraft owner I am a pilot I am an aircraft mechanic

Name * First Last

Email *

Aircraft Owners

If you own an aircraft and wish to donate its use for On His Wings Foundation missions, please complete this section.

Aircraft Make

Aircraft Model

Additional Aircraft info you would like to include.

Home Airport

Are you willing to add On His Wings Foundation as an additional insured?

Yes No

Pilots

If you are a pilot, please complete this section.

Certificates Held (check all that apply)

SEL MEL SES MES IFR COM ATP CFI CFII MEI

Medical

First Class Second Class Third Class

Total Single Engine Time

Total Multi Engine Time

Total Instrument Time

Aircraft Mechanics

If you are an aircraft mechanic, please complete this section.

FAA Authorizations (check all that apply)

A&P IA Other

Please describe your experience.

Conclusion

Please let us know of any comments or questions that you might have.

By submitting this form, I agree to the following:

I acknowledge that On His Wings Foundation is acting only as a facilitator in coordinating my services as an aircraft owner, pilot, or mechanic for any mission I may participate in. I understand that I will fulfill the mission at my own risk, and agree that I will hold harmless On His Wings Foundation, its officers, directors, agents, staff, or associates for any claim made against it associated with my actions in performing a mission. Finally, I agree to: (a) notify my liability insurance carrier that it is to name On His Wings Foundation as an additional insured on liability insurance covering my actions while on any mission; and (b) to confirm that an appropriate endorsement has been issued. I acknowledge that On His Wings Foundation will not confirm my insurance coverage, and I will not conduct any mission if such coverage is not in place with On His Wings Foundation named as an additional insured. I also agree to abide by any operational guidelines set forth by On His Wings Foundation while conducting a flight on its behalf and to follow any applicable rules set forth by the Federal Aviation Administration. I give the On His Wings Foundation permission, at On His Wings Foundation's option, to list information contained on this application and pass it on to other On His Wings Foundation staff.