Membership Type *

Contact Information

First Name *

Last Name *

Email Address *

Please confirm *

Contact Allowed

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number *

Country *

USHPA Pilot Ratings

You MUST be a Current Member of USHPA to join CUASA. Please visit USHPA and CUASA's websites for more information about membership benefits and insurance.

USHPA Membership Number * 🛈

USHPA Expiration Date +

What Type of Gliders Do You Fly? *

Total Foot Launched Hours *

Total Mountain Hours *

Hang Glider Ratings

HG Pilot Rating *

HG Tandem Rating

Paraglider Ratings

PG Pilot Rating *

PG Tandem Rating

MiniWing / Speedwing Rating

Emergency Contact Information

While not required, we STRONGLY urge you to supply Emergency Contact Information.

Emergency Contact's First Name

Emergency Contact's Last Name

Emergency Contact's Phone Number

Emergency Contact's Relationship To Pilot

Waiver Of Legal Rights

AFFIRMATION OF UNITED STATES HANG GLIDING AND PARAGLIDING ASSOCIATION RELEASE, WAIVER AND ASSUMPTION OF RISK AGREEMENT AND ACKNOWLEDGMENT OF APPLICABILITY TO USHPA CHAPTER

Flight Under FAA Regulation "Part 103 is based on the assumption that any individual who elects to fly an ultralight vehicle has assessed the dangers involved and assumes personal responsibility for his/her safety". FAA AC-103-7

In consideration of being allowed to use the facilities and participate in the sport of "Ultralight Vehicles" and other activities (collectively the “Activities”) provided by Central Utah Air Sports Inc. (the "USHPA Chapter"), I hereby reaffirm the United States Hang Gliding And Paragliding Association (“USHPA”) Release, Waiver and Assumption of Risk Agreement (the “USHPA Release”) previously signed by me and acknowledge that it is applicable to my participation in any and all Activities of the USHPA Chapter. Each of the terms, including the definitions, of the USHPA Release are hereby incorporated by reference as though fully set forth in this affirmation. I specifically acknowledge that the following persons, including their owners, officers, directors, managers, agents, spouses, employees, officials (elected or otherwise), members, independent contractors, sub-contractors, lessors and lessees, are also RELEASED PARTIES as that term is used in the USHPA Release: Central Utah Air Sports Inc., and each of its members, employees, agents, volunteers, officers, directors, and managers; Monroe City, USDA Forest Service, Mid-Utah Radio, Bureau of Land Management, Cindy Stanton; This specification of certain RELEASED PARTIES is not meant to be an all-inclusive list or to limit in any way the scope of persons included within the definition of RELEASED PARTIES in the USHPA Release. Rather, it is made to give assurance to those listed here that they are included within the scope of the definition of RELEASED PARTIES in the USHPA Release. "Ultralight Vehicles" includes powered and unpowered hang gliders and paragliders. Mini-wings and speed-wings are types of paragliders. This affirmation in no way limits, restricts or narrows the terms or scope of the USHPA Release previously signed by me.

Member Signature * 🛈

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