Standard 623 - Appendix A - PARTICIPANT’S STATEMENT - Canadian Aviation Regulations (CARs)

Content last revised: 1999/09/01

Date: ____________

Page ______ of _______

This is to certify that I have read and thoroughly understand and will comply with all the Conditions contained in the Special Flight Operations Certificate issued for______________________
(Enter Name of Special Event)

Participant's Name	Participant's Signature
1. ________________________________ 2. ________________________________ 3. ________________________________ 4. ________________________________ 5. ________________________________ 6. ________________________________ 7. ________________________________ 8. ________________________________ 9. ________________________________ 10. ________________________________ 11. ________________________________ 12. ________________________________ 13. ________________________________ 14. ________________________________ 15. ________________________________	________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________

Participant's Name

Participant's Signature

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Standard 623 - Appendix A - PARTICIPANT’S STATEMENT - Canadian Aviation Regulations (CARs)