Transponder

I have my own transponder  *

with no. *

I don't have my own transponder *

For more information or to order contact Meik Wagner +46 70-428 9936 or info@mwraceconsulting.com

* one transponder option has to be filled in

Entrant (Entrants without ASN licence numbers will not be published on official paperwork)

Name

ASN Licence no.

Championship / Events

Complete series

Nysum 1-2 May

Höljes 13-16 May

OuluZone 5-6 June

Arvika 13-15 August

Championship fee  for complete series Supercar SEK 48 000:- / single events SEK 15 000:- / single entry Arvika 8 000:- + 6% tax

Championship fee  for complete series Supercar Lites SEK 48 000:- / single events SEK 15 000:- / single entry Arvika 8 000:- + 6% tax

Championship fee  for complete series CrossCar SEK 28 000:- / single events SEK 8 500:- / single entry Arvika 5 000:- + 6% tax

Championship fee  for complete series CrossCar Junior SEK 18 500:- / single events SEK 5 500:- / single entry Arvika 3 500:- + 6% tax

Championship fee  for complete series Open 2WD SEK 28 000:- / single events SEK 8 500:- / single entry Arvika 5 000:- + 6% tax

Entries to individual competitions will be accepted on the basis of space.

Championship fee will be invoiced by RX Promotion AB

Enter the invoice recipient

Name *

Address *

Post code *

Town / Country *

Organisation no.*

VAT no.*

required fields *

Team

Name

(Notice! Team name will be shown during the TV broadcast)

Paddock information

Total surface for service vehicle + service tent

width *

metres

length *

metres

Additional information

(like sharing paddock space with other drivers, etc.)

Extra electricity (ORDER)

400 V 16 A

quantity

400 V 32 A

quantity

Electricity included in the entry fee is 1 pcs. 230 V 10 A for all classes per competitor

Electricity which is not ordered in this entry form can not be guaranteed

required fields *

Contact person for team/driver (Notice! Person responsible for all communications relating to the series promoter and all events)

Name *

E-mail *

Mobile phone *

required fields *

I HAVE READ AND AGREE TO BE BOUND BY THE PRIVACY POLICY AS WELL AS ALL SPORTING, COMMERCIAL AND PADDOCK REGULATIONS *

required fields *