Life Lion Public Relations Request Form

Request type

Life Lion Critical Care – AirLife Lion Emergency Medical Services – Ground

Acknowledgement

I have read and agree to the following guidelines for helicopter appearances.

Guidelines: The on-site contact for the day of your event needs to have recently completed our landing zone training course and will be required to secure the area and appropriately brief our crew on all potential obstacles, hazards, and known UAV/drone activity.

Requester Information

Requesting Organization Name

Requesting Organization Address (Include street name, city, state and zip code)

Name

Phone - Work

Phone - Home

Email Address

Requesting Organization type (Choose one of the following that best represents your organization type)

If other is selected, list your organization type here

Event Details

Event type: (Choose one of the following event types)

If other is selected, list the event type here.

Event Description

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Time of Event

Date of Event

Length of Event

Number of People Expected

Event Location Details

Event Address

City

State

Zip Code

Event Location Details: (Cross streets, nearest intersection, GPS coordinates, radio frequency and contact.)

Event Day Contact Information

Please provide contact information for the day of your event. Please include a cell phone number for contact the day of the event.

Contact Name

Contact Cell Phone Number

Event Day Drone/UAV Flight Activity

Please provide information on known or anticipated Drone/Unmanned Aerial Vehicle flight activity in the area of your event.

Contact/Operator Name

Contact/Operator Cell Phone Number

Other Known Details

Contact Information