Registration

Competitors entry form 2015 - CAR / TRUCK

Please, fillin and submit the entry form. Your entry becomes definitive upon reception of the full amount of entry fees due. For detail, refer to registration fees conditions.

DRIVER/PILOT N1
Family Name*
First Name*
Male/Female*
Date of Birth*
Nationality*
Passport No*
Place of issue*
Issue date*
Expiry date*
Licence No (not obligatory)
Federation
Driving Lic No*
Blood type*
Telephone No
Mobile No*
Fax No
E-mail*
Address*
City*
Zip/Post Code*
Country*
Emergency contact person*
Relationship*
Telephone No*
Competing in other rally raids*
DRIVER/PILOT N2
Family Name*
First Name*
Male/Female*
Date of Birth*
Nationality*
Passport No*
Place of issue*
Issue date*
Expiry date*
Licence No (not obligatory)
Federation
Driving Lic No*
Blood type*
Telephone No
Mobile No*
Fax No
E-mail*
Address*
City*
Zip/Post Code*
Country*
Emergency contact person*
Relationship*
Telephone No*
Competing in other rally raids*
DRIVER/PILOT N3
Family Name
First Name
Male/Female
Date of Birth
Nationality
Passport No
Place of issue
Issue date
Expiry date
Licence No (not obligatory)
Federation
Driving Lic No
Blood type
Telephone No
Mobile No
Fax No
E-mail
Address
City
Zip/Post Code
Country
Emergency contact person
Relationship
Telephone No
Competing in other rally raids
ТЕАМ
Team title
VEHICLE IN RACE
Class*
Make*
Model*
Year*
Engine cc*
Traction*
Registration No*
Country of registration*
Chassis No*
Engine No*
Owner*
Insurance company*
Contract No*
Expiration date*
ASSISTANCE CAR
Make
Model
Registration No
Trailer No
Assistant N1 (name)
Assistant N2 (name)
I, declare that to the best of my knowledge all the information provided above is correct. I understand that the demand is considering as an order form.
I understand that it is our unique responsibility to ensure that all the documents required to participate in the "Balkan Marathon Rally" are valid, especially my driving licence, my vehicle ownership and insurance documents. I declare that we enter the "Balkan Marathon Rally" in full knowledge of the risks such a race involves and renounce in advance all responsibility on the part of the organisers of the "Balkan Marathon Rally", penal or civil in case of bodily or material accident or death during the rally. I declare, I've read and approved the entry fee conditions and the regulation of the Rallye.
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