Anmeldelsesblanket / Entry Form

RECONNAISSANCE CAR REGISTRATION FORM

This form must be submitted to the Rally Office during reconnaissance registration.

Kørere / Drivers

Kører / Driver
Navn:
Name:
Adresse:
Address:
Postnr./By:
Zip Code/City:
Telefon:
Telephone:
Nationalitet:
Nationality:

Bil / Car

Fabrikat:
Make: / Model:
Type:
Farve:
Colour: / Registreringsnr:
License plate no:
Entry Class:
Vi erkender at være underkastet denne konkurrences tillægsregler og udsendte bulletiner, FIA’s internationale Sporting Code, Generelle Forskrifter for Rallyer i Danmark og løbets tillægsregler. FIA, DASU,den arrangerende klub eller disses konkurrence-funktionærer kan ikke gøres ansvarlig for nogen som helst skade, som vi eller køretøjet måtte forvolde på egen person og/eller tredie person eller dennes ejendom. / We accept to follow the supplementary regulations and regulating bulletin’s of this competition, the FIA International Sporting Code, the General Presrictions for Rallies in Denmark and the Supplementary Regulations. FIA, DASU, the organizers or any officials of the event cannot be made responsible for any damage or injury, which we or our vehicle may cause to ourselves and/or third party or third party’s property.

Underskrifter / Signatures:

Anmelder / Entrant: / 1. kører / Driver: / 2. kører / Co-driver:

This form shall be send to: Anne Møller-Nielsen