Complaint Form E-mail Subject
MEDICAL INDEMNITY IN FAVOUR OF AIRLINK (PTY) LIMITED MEDICAL INDEMNITY IN FAVOUR OF AIRLINK (PTY) LIMITED
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kmosana@flyairlink.com
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MEDICAL_INDEMNITY_FORM
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MEDICAL INDEMNITY IN FAVOUR OF AIRLINK (PTY) LIMITED
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Name
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I have booked passage on flight/s to be operated by Airlink (Pty) Limited as follows:
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I have disclosed to Airlink that I have a temporary or permanent medical or physical
condition and that as a result I require
additional assistance in relation to the Airlink flight that I am going to take.
condition and that as a result I require
additional assistance in relation to the Airlink flight that I am going to take.
I acknowledge that Airlink will use reasonable endeavors to accommodate my specific
needs but also ensure the safety and comfort of other passengers on board the flight.
needs but also ensure the safety and comfort of other passengers on board the flight.
I unconditionally indemnify and hold harmless Airlink, its directors, officers, employ
ees, and agents involved in any aspect of the operation of the flight in question or
any related service such as baggage and cargo handling for:
ees, and agents involved in any aspect of the operation of the flight in question or
any related service such as baggage and cargo handling for:
points
Any loss, damage, or injury of whatsoever nature that I may suffer in the course of being a passenger on the flight, embarking or disembarking from the aircraft in question or being conveyed at any time through either the airport of departure or arrival. I understand that this indemnity does not extend to any loss, damage, or injury that I may sustain as a result of any conduct which is of a grossly negligent nature; and
Any loss of a damage to any medication, therapeutic or medical equipment of any nature (including but not limited to assisted mobility devices such as crutches or wheelchairs) that I may bring with me on the flight whether it stowed in the cargo hold of the aircraft or kept in any portion of the main cabin during the course of the flight. Once again, I understand that this indemnity does not extend to any loss or damage to such equipment that may be caused by any grossly negligent conduct.
I understand that as set out in this document, I am otherwise entitled to the same
rights and benefits as all other Airlink
passengers as described in the Conditions of Carriage.
rights and benefits as all other Airlink
passengers as described in the Conditions of Carriage.
I confirm that I am aware that it is my duty to ensure that I am declared fit to travel on the flight by a competent and
qualified medical and/or therapeutic practitioner and further that I have procured that I am insured against any loss or
injury which I may sustain, whether to my person or property and in respect of which I indemnified Airlink, alternatively
I have chosen not to avail myself of such insurance but in either event, this in no way impacts upon the extent of the
indemnities that I have freely given, as described above.
qualified medical and/or therapeutic practitioner and further that I have procured that I am insured against any loss or
injury which I may sustain, whether to my person or property and in respect of which I indemnified Airlink, alternatively
I have chosen not to avail myself of such insurance but in either event, this in no way impacts upon the extent of the
indemnities that I have freely given, as described above.
I confirm further that Airlink’s requirement that I give this indemnity and make these
declarations is reasonable in the
circumstances and not unfairly discriminatory. I understand the nature of the indem
nity that I have given, and the
content of the declarations made in this document, and I confirm them to be correct.
declarations is reasonable in the
circumstances and not unfairly discriminatory. I understand the nature of the indem
nity that I have given, and the
content of the declarations made in this document, and I confirm them to be correct.
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declaration Text
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I confirm that I have read and understood this medical indemnity form and agree to this consent.