Wheels Up: - Rockcliffe Flying Club

Wheels Up: _______________ Estimated Duration: ____________ Date:DD / MM / YYUTC: ________Wheels Down: _______________ Destination ETAAircraft Registration: C - __ __ __ __Local: ________Radio FrequenciesEmergency / ELT 121.5En Route FSS 126.7Rockcliffe UNICOM 123.5Checkpoint-Location0 1 2 3 4 5 6 7ABCDEFGCompass Heading Planned(degrees) CorrectedAltitude (ASL)(feet)Zulu Time Over(hr : min): : : : : : : :(hr : min) : : : : : : :Time Over PreviousElapsed Time (min)(A – B)Distance Covered(nm)Ground Speed (kts)(D ÷ C x 60)Distance Remaining(F – D)Time Required(F ÷ E) [2 nd ][6] : : : : : : : :Revised ETA(G + A) : : : : : : :Report Position,Time Over & ETANotes: [2 nd ][6] refers to CX-2 key entries.Fold Along LineTransponder CodesAssigned VFREmergency 7700Lost Radio 7600ATC < 12,500 ft 1200Mike Dervin #4007

X-Country Check-ListEmergency Action-ListRecord take-off timest1 Priority: Fly The AirplaneOpen Flight Plan (FSS 126.7 Mhz) ClimbLean Mixture > 3000ftSet Transponder Code 7700Set heading-indicator with compassRevise ETAAdjust course & speed as requiredPosition Report:Aircraft type & call-signAt time _______ (Zulu) overPosition / checkpointAltitude, Airspeed & HeadingVFR flight plan to _________(Revised) ETA of _________ (Z)Verify fuel rate & quantityCheck Engine GaugesCheck Electrical LoadCheck For Carb’ IceCheck BrakesObtain ATIS / get weather info.Set altimeter’s barometerCheck runway cross-windCX-2 [Flight] [5] [4]Make landing approach radio callsContact ATC / transmit on 121.5MAYDAY, MAYDAY, MAYDAYCall-sign x 3MAYDAYAircraft type & call-signNature of distress / urgencyPilot’s intensions / requestParticulars:PositionAltitude____________________________Airspeed ______________Heading ______________No. of people on-boardCall-signLand (as appropriate):Divert to nearest airport;Precautionary landing; orForced landing.Close Flight Plan