中国东方航空股份有限公司
风险告知确认书
根据《中华人民共和国民用航空法》、《蒙特利尔公约》、《中国民用航空旅客、行李国内运输规则》及《中国民用航空旅客、行李国际运输规则》中关于限制承运人承运的相关规定,乘机人的身体状况属于: 。中国东方航空股份有限公司已经将有关规定以及乘机过程中可能导致身体伤害的风险向乘机人做出详尽解释和说明,建议乘机人慎重考虑。
对于中国东方航空股份有限公司的解释和告知,乘机人对乘机过程中可能出现的伤害、病情加重甚至是死亡等上述风险有了明确的认识。乘机人仍要求乘坐________年________月_______日__________航班从__________飞往__________,愿意自行承担由此可能产生的上述人身损害及损失的后果,并承诺不向中国东方航空股份有限公司及其受雇人/代理人提出任何赔偿请求或者索赔主张。
特此确认。
乘机人: _____________________
身份证号码:
日期:________年______月______日
China Eastern Airlines Co., Ltd.
Risk Notice and Acknowledgement
The Passenger has the following circumstance where under the Civil Aviation Law of People’s Republic of China, Montreal Convention, Civil Aviation Rules of Domestic Carriage of Passenger and Baggage, and Civil Aviation Rules of International Carriage of Passenger and Baggage the carriage of such Passenger shall be subject to certain condition:
_____________________________________________________________________________________________________________________________________________________. China Eastern Airlines Co., Ltd. (the Airlines) has duly notified the Passenger of the possible physical risks during the transportation, together with relevant laws and regulations which is applicable, and the Airlines mend the Passenger to consider with deliberation. .
The Passenger hereby acknowledge that he/she is fully aware of the possible risk, including but no
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