Aviation Club Form AVIATION CLUB APPLICATION Step 1 of 3 – PERSONAL INFORMATION 0% Your Personal InformationYour Name(Required) First Middle Last Date Of Birth(Required) DD slash MM slash YYYY Gender(Required) Female Male Other Your Email Address(Required) Nationality(Required)Address(Required) Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Your Phone(Required) Membership DetailsMembership Type:(Required)Membership Fee: KES 1,000 (one-time registration fee) || Termly Fee (3 months): KES 5,000 per termNew Membership (Registration Fee + Termly Fee)Renewal (Termly Fee)Preferred Start Date:(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Payment InformationHow do you prefer to pay the fees? Bank Transfer Mobile Payment (e.g., PayPal, M-Pesa, etc.) In-Person Payment Payment Confirmation Number (if applicable): Parent/Guardian Information:Parent/Guardian Name: Prefix Dr.MissMr.Mrs.Ms.Mx.Prof.Rev. First Last Relationship to Applicant:PhoneEmail Emergency ContactEmergency Contact Name:(Required) First Middle Last Phone(Required)Membership Information:Why do you want to join the Highwing Aviation Club? (Please provide a brief explanation):How did you hear about Highwing Aviation Club? Website Family/Friend Social Media Event/Advertisement Other Declaration and Signature:I, the undersigned, declare that the information provided is accurate to the best of my knowledge. I understand that my membership will be confirmed after payment of the required registration and termly fees. I agree to abide by the rules and regulations of Highwing Aviation Club.Applicant Signature(Required)Parent/Guardian Signature (if applicant is under 18):(Required)Date(Required) DD slash MM slash YYYY Date(Required) DD slash MM slash YYYY Terms and Conditions(Required)Welcome to the Highwing Aviation Club! By completing the application form and becoming a member, you agree to the following terms and conditions: — 1. Membership Eligibility – Applicants must provide accurate personal information as detailed in the application form. – Members under the age of 18 must have a parent or guardian complete the application and sign the consent section. 2. Membership Fees – **One-time Registration Fee:** KES 1,000 – **Termly Fee:** KES 5,000 per 3-month term – Fees are due upon completion of the application form and must be paid to confirm membership. 3. Payment Methods – Members can choose to pay via: – Bank Transfer – Mobile Payment (e.g., PayPal, M-Pesa, etc.) – In-Person Payment – A payment confirmation number must be provided if applicable. 4. Membership Duration – Membership is term-based and will automatically renew unless a cancellation request is submitted one month before the end of the current term. 5. Code of Conduct – All members are expected to adhere to the rules and regulations of the Highwing Aviation Club. – Disruptive behavior, harassment, or violation of safety protocols will result in immediate suspension or termination of membership. 6. Liability Waiver – Members participate in club activities at their own risk. Highwing Aviation Club will not be liable for any injuries or losses incurred during club activities. 7. Use of Personal Information – The information provided in the application will be used solely for membership purposes and will not be shared with third parties without consent. 8. Emergency Contacts – Members are required to provide emergency contact details. In the event of an emergency, the club reserves the right to contact the listed individuals. 9. Feedback and Membership Cancellation – Members can provide feedback on their experience. Membership can be canceled at any time by submitting a written request to the club. 10. Changes to Terms and Conditions – Highwing Aviation Club reserves the right to modify these terms and conditions at any time. Members will be notified of any significant changes. — By signing the application form, you acknowledge that you have read, understood, and agree to abide by these terms and conditions. I agree to the terms and conditions.
