Entry form for 7th Czech New Energies Rallye | 17. – 19. 5. 2018 Championship Title --FIA Electric and New Energy ChampionshipCzech Trophy in ECO Rally Favorite starting town of Concentration Leg Starting town --Humpolec (CZ)Rainbach im Mühlkreis (A)Písek (CZ) Organiser can be change starting town of Concentration Leg at the latest two weeks before event. Competitor Name of the team Car Make Model Type of drive --electrohybridplug-in hybridhydrogenCNGLPGethanolbiodiesel Year of Manufacture Registration No. Country of Registration Charging in Parc Fermé --YESNO Compulsory for FIA E-Rally Regularity Cup! Driver Family name First name Nationality Date of birth Postal address City ZIP Code Country Driving licence No. Country of issue Mobile Telephone No. E-mail Competition licence owner --YESNO T-Shirt size --SMLXLXXL3XL Co-driver Family name First name Nationality Date of birth Postal address City ZIP Code Country Driving licence No. Country of issue Mobile Telephone No. E-mail Competition licence owner --YESNO T-Shirt size --SMLXLXXL3XL Please leave this field empty. Closing date for entries: April 30, 2018, 24:00 Charges Entry fee: 480 € FIA Driver’s licence / Accident insurance: according ASN of each state Prices include VAT. Entry fee include participation in rally third party liability insurance car and crew designation roadbook with map professional timekeeping and processing of results polo shirts commemorative plaques souvenir trophies for winners transfer from the Parc Fermé to the accommodation in Český Krumlov (Thursday – Saturday) Green taxi Český Krumlov (CNG vehicles), +420 380 712 712 ticket to pre-start gala dinner with reception – Hotel Růže, Český Krumlov lunch during the Leg 1 – Exhibition area České Budějovice, Pavilion Z dinner after the Leg 1 finish – Brewery Restaurant, Český Krumlov lunch during the Leg 2 – Restaurace Lanovka, Lipno nad Vltavou ticket to official Rally Afterparty – City Lounge music club & bar Payment Account No.: 2102956758/2700 UniCredit Bank České Budějovice IBAN: CZ34 2700 0000 0021 0295 6758 SWIFT: BACXCZPP Note: Driver’s name Charges must be sent to promoters account at the latest April 30, 2018.