Flock & Dock 4.0 Registration $45
   
 

Please fill out and submit this form to order. Fields marked with (**) are
required for US and Canadian residents only.

  Customer Information  
 
Customer Name
      
 
Address
      
 
City
      
 
**State
      
 
Zip/Postal Code
      
 
Country
      
 
Phone
      
 
Email
      
 
Height
     
 
Weight
      
 
USPA Member #
    (or equivalent)
 
License #
   
 
License Expiration
     
 
Total Jumps
     
 
Total Jumps
  in the past 12 months 
 
Total Wingsuit Jumps
      
 
Total Wingsuit Jumps
    in the past 12 months
 
Type of Wingsuit
     
 
Main Canopy
      
 
Preferred Deployment
  Altitude on WS Jump 
 
Credit Card Type
   Visa , Mastercard, Discover (checks & money order no additional charge )  
 
Credit Card Number
   if not comfortable emailing CC info please fax info too 813 788 7072 
 
Expiration Date
  or call 813 780 8961. Thanks
 
CID Code
      
 
Billing Address
   if different than above
 
T-Shirt Size
     
 
Flock n Dock 4.0
  $45  
 

Registration includes…

• Large Wingsuit Formations concentrating on formation flying.
• Medium Wingsuit Formations concentrating on sequential flight.
• Video on most jumps.
• All abilities welcome.
• Phoenix Fly wingsuit demos available.
• Phoenix Fly tracking pants and jacket demos available.
• Wingsuit formation flying, flocking, coaching, etc…
  What type of Flying do you enjoy and want to participate in at Flock and Dock 4.0 (big ways, small flocks etc)  
 
         
       
         

 

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