ISLE OF MAN CIVIL AVIATION ADMINISTRATION St George’s Court, Upper Church Street, Douglas, Isle of Man, IM1 1EX, British Isles Telephone: +44 (0)1624 682358 Fax: +44 (0)1624 682355 Email: aircraft@gov.im Notification of Outdoor Laser, Searchlight, Firework, Helium-Filled Toy Balloon or Sky Lantern Events Note: Fields marked with an * are mandatory. Please complete the form electronically, or in block capitals using black or dark blue ink. 1. APPLICANT DETAILS *Name: *Address: *Postcode: *Telephone No: *Email: Job Title / Organisation: 2. EVENT DETAILS (Note: When practicable 28 days’ notice should be given of the event) *Brief Description of Event: *Date of Event: Daily Period (in local time): *From: *To: If there are multiple events or testing prior to the event please give details below: 3. LOCATION DETAILS URL Link to Location on Webpage: Ordinance Survey Grid Ref: Or, WGS84 Co-ord: Lat: Long: *Contact Telephone Number at Site: *Site Address: *Postcode: Maximum Display Height: (Fireworks only – For toy Balloons and Sky Lanterns enter ‘Unlimited’) AGL ft 4. RELEASE DETAILS – TOY BALLOONS or SKY LANTERNS ONLY (Note: Balloons must be made of Latex/Rubber, NOT metallic or with a metallic finish) Quantity to be Released: Method of Release: Batch Mass Individual If Batch selected, please indicate the number of occurrences: 5. DECLARATION By submitting this document I, as the event organiser, declare that I have checked the above information and that to the best of my knowledge it is correct and that I am aware of my obligations under The Air Navigation (Isle of Man) Order 2015. Name: Date: When completed please send this form to: Air Traffic Services, Isle of Man Airport, Ballasalla, Isle of Man, IM9 2AS Tel: 01624 821629 Fax: 01624 821722 Email: ATCSupervisors@gov.im Form 65 Issue 5
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