8. Czech New Energies Rallye | 16. – 18. 5. 2019

Entry fee for a crew include:

Charges

Entry fee: 490 €
Liability insurance to use of vehicle during organized motoring event: 5 €
FIA licences for both members of a crew including compulsory personal insurance: 51 €

Entry fee payment is a condition for inclusion of crew to list of entries.

Prices include VAT.

Start of the rally

Starting town

Competitor

Name of the team

Vehicle

Manufacturer
Model
Year of manufacture
Predominant color
Registration plate
Country of registration
Chassis number (VIN)
Weight (kg)
Tyres data
Type of drive

Electric vehicle technical information

Battery manufacturer
Battery type
Nominal battery energy (kWh)
Usability battery energy (kWh)
Battery voltage (V)
Autonomy (km)
Operating range (km)
Consumption (Wh/km)
Connectors types (AC/DC)
Recharging current Mode 2 (A)
Plugs types
Recharging cable length (m)

Driver

Family name
Given name
Nationality
Date of birth
Postal address
Town
ZIP code
Country
Driving licence number
Country of issue
Mobile phone number
Email
Competition licence owner
Competition licence number
Clothing size

Co-driver

Family name
Given name
Nationality
Date of birth
Postal address
Town
ZIP code
Country
Driving licence number
Country of issue
Mobile phone number
Email
Competition licence owner
Competition licence number
Clothing size
Participant agree with sharing email addresses contained in this entry form to the other ERRC Organisers to distribute invitations to other events.

Closing date for entries: May 5, 2019, 24:00

By submitting your entry form you:

• agree with to use of email contacts for a purpose to distribute information relating to the competition
• agree that photos and videos of your crew and vehicle taken during the event may be published

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, 2019.