FLIGHT OPERATIONS DEPARTMENT Consent for Drug and Alcohol Testing

I, Full Name * do hereby agree to submit to random urine drug/alcohol testing as part of DGCA-Kuwait requirements to help ensure the safety and well-being of our clients. I understand that Jazeera Airways may ask me to submit to such a test at any time and I am prepared to comply with the request(s).

I am aware that the results of these random drug/alcohol tests will be utilized to help determine my ability to provide a safe environment for our clients.

I give my consent to release the results of the random urine drug/alcohol tests and other
medical information from the Laboratory (JGSC Laboratory) to my employer (Jazeera Airways) pursuant to statute or regulation.

I further understand that a positive test, refusal to authorize this form, refusal to take the
test, or failure to produce a specimen, may result in disciplinary action up to and including
in accordance with the law of the State of Kuwait in collaboration with DGCA-Kuwait
regulations and policy.