Remotely Piloted Aircraft – Request for Approval

Please fill out the form below to request approval to operate a Remotely Piloted Aircraft within 4km of Kapiti Coast Airport.

Be careful to answer ALL fields accurately in order to avoid unnecessary delays in approving your request.
An approval cannot be granted unless you meet ALL necessary requirements applicable to Civil Aviation Rule Part 101.205

Basic Information

Pilot Name:

Pilot Phone Number:

Mobile:

Business:

Email:

Details of Flight Operation:

Flight Operation Summary

Type of Operation:

Aircraft Type:

Civil Aviation Rule (CAR) Part will you be operating under:

Do you have a certified transponder?

Will you have VHF radio contact?

Is your flight a shielded operation?

Date:

Multi-Day Operation?

Start Time:

Final Finish Time:

Flight Area on Map

Get My Position

Address:

Or drag the marker to a specific location

GPS Co-ordinates:

Maximum Height:

Area Coverage:

m^radius

Describe capability/procedure to measure altitude (if any):

Additional Information

Describe your emergency procedure, if you have one:

Other information you believe pertinent to the operation:

Have you filed an Airshare Flight Plan?

Have you obtained consent from the property owner?

Airshare Flight Plan number (if applicable):

Have you had previous RPAS approval granted before?

Safety Observer

Safety Observer Name:

Safety Observer Phone Number:

Mobile:

Any Relevant Certification

Do you have any RPAS qualification, or pilot licence?

Qualification or pilot licence:

Number:

Type of qualification or pilot licence:

Qualification or licence issued by:

Any further details applicable to your qualification:

Submit Approval Request

An approval granted by Kapiti Coast Airport Holdings Ltd (the Airport Operator) confirms that the above RPA Operator has been authorised to operate the above RPA within 4 kilometres of Kapiti Coast Airport at the location described above, during the period of the approval, and subject to the following conditions:

1. Compliance with all aspects of Civil Aviation Rule Part 101 at all times, or Operating Certificate if operated under Rule Part 102;
2. Compliance with the Airport Operator's Standard Conditions for RPA operations within 4km of Kapiti Coast Airport;
3. Compliance with any further conditions and/or restrictions as notified by the Airport Operator in an approval given;
4. The safety measures stated above are put in place and adhered to;
5. The permission of the property owner or occupier will be obtained before operating over any property;
6. The approval may be immediately terminated by the Airport Operator in the event of a breach of the conditions or an unsafe situation arising.

I acknowledge that I have read, understood, and agree to comply with the Standard Conditions and all aspects of any granted approval when operating the above RPAS aircraft within a 4km radius of Kapiti Coast Airport. I understand that any approval given is only applicable to the details provided above, and is not transferable. I also indemnify Kapiti Coast Airport Holdings Limited (the Airport Operator) from any liability arising from my actions under any such approval.