Application form

1) Complete and submit the application form below

2) If you have not been assigned a start number, you will receive one at the numbers listed below or by email.

3) Each rider will complete a Rider Declaration and GDPR. Submit/send completed forms to pa.vca@arcbrno.cz

Date and place of race*

Competitor - team*

Starting number*

Starting number (if asigned)

1. Competitor - First name/Last name/Birth date*

2. Competitor - First name/Last name/Birth date*

3. Competitor - First name/Last name/Birth date

4. Competitor - First name/Last name/Birth date

5. Competitor - First name/Last name/Birth date

Car make*

Car type*

Fuel*

Engine*

Responsible (contact) person*

Birth number*

Address*

E-mail*

Phone number*

Message

By submitting the form, I confirm that all team members acknowledge that they participate in the regularity ride at their own risk and are fully responsible for the damage or injury they cause.

Other information:

Petr Verner tel.: +420 737 216 790, Pavel Verner tel.: +420 739 735 824

Email: info@arcbrno.cz or pa.vca@arcbrno.cz

The amount of the entry fee, including the payment terms, is specified in a special provision issued for a particular sports event.