Registration 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 team driver will complete a Driver Declaration and GDPR. Submit/send completed forms to pa.vca@arcbrno.cz

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

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 *

Engine *

Fuel *

Will you bring your own fuel and refueling system? *

Responsible (contact) person *

Birth date *

Address *

E-mail *

Phone number *

Billing Information:

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

E-mail: info@arcbrno.cz or pa.vca@arcbrno.cz

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