Pilot Mound Balloon Festival Pilot Registration Form
Registration Deadline: June 30th, 2007



Hello Pilots!

All of the fields below are required. If a particular field does not apply to you, please type "N/A" or "Not Applicable" in that particular field, otherwise you'll receive an error message. Thanks!



If you have any questions, you may call Larry Bridges at 204-825-2442 (work).

Pilot Registration Deadline is June 30th, 2007

* Your first and last name:
* Your address:
* City:
* Province/State:
* Postal/Zip:
* Your phone number:
* Email:
* Balloon Manufacturer and Year:
* Balloon Size:
* Balloon Registration #:
* Balloon Name:
* Balloon Color Pattern:
* Balloon Registered Owner's Name:
* Last Annual Inspection:
* Last Biennial flight reveiw:
* Total Hours on Balloon:
* Insurance Company:
* Policy Limits:
* Insurance Expiration Date:
* Total Logbook Hours:
* Pilot Ratings:
* Number of passengers you can take per trip:
* Number of local ground crew needed?:
* How many beds will you need for yourself and your crew?
* What day will you be arriving?


If you have pictures or any other information you'd like to send to us which can be used for promotion purposes, please provide that information in the box below. This information may be used on the website as a "Meet the Pilots" promotion, or in other promotional capacities.Pictures can be emailed to: villagewebdesign@mts.net

or mailed to:
Pilot Mound Retail Merchants Association
Box 399
Pilot Mound, Manitoba
R0G 1P0

Thank You!