Entry form Best of the Alps Classic Rally 2016

DRIVER

Name Driver*

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Surname Driver*

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Date & Place of birth*

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Address*

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City*

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ZIP Code*

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Country*

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Phone N° *

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Cell Phone N° on the rally

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Email adress*

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Passport N° / ID*

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CO-DRIVER

Name Co-driver

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Surname Co-driver

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Date & Place of birth

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Adress

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City

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ZIP Code

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Country

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Phone N°

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Cell Phone N° on the rally

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Email Adress

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Passport N° / ID

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Clothing size

S

M

L

XL

VEHICLE INFORMATION

Brand*

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Model*

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Year*

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Registration number*

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Insurance Company*

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Repatriation Insurance Company

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Possible replacement oldtimer vehicle

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ACCOMMODATION

Type:*

Twin (2 single beds)

Double (1 double bed)

Single (2 personal rooms - on request)

PAYMENT

Type of payment:*

payment in cash

payment by bank transfer (possible bank charge)

online payment

I commit myslef to send a pre-payment of 1000 euros to SARL «Doka Productions» to confirm my registration and I will also pay the remaining 3150 euros before May 1st 2016.

I declare that my vehicle is in compliance with the french highway code, that my driver licence, the one of my co-driver and my insurance certificate are valid. I have a repatriation contract for my crew and my vehicle. I undertake not to seek redress from the organisers for any kind of reason, except a serious offence.

I took full notice of the general terms from the entry form.

Attention

DRIVER

CO-DRIVER

VEHICLE INFORMATION

ACCOMMODATION

PAYMENT

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