Driver

 

 

 

 

Start no. wish

 

First name *

 

Last name *

 

Address *

 

Post code *

 

Town *

 

Country *

 

E-mail *

 

Phone no. *

 

Mobile phone *

 

Website

 

License class + no. *

 

Personal ID no. *

 

Club (on license) *

 

Nationality *

 

Car make / model *

 

required fields *

 

 

 

Transponder

I have a own transponder  *

with no. *

 

I have no own transponder *

 

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

* one transponder option has to be filled in

 

 

Entrant (Entrant´s without ASN license number´s will not be published on all official paperwork)

Name

 

ASN License no.

 

Championship / Events

 

Complete series

 

Höljes 17-19 may

Nysum 1-2 june

Riga 20-21 july

Finnskogbanen 27-28 july

Kuovola 24-25 august

Tierp 21-22 september

Championship fee  för complete series Super Car Lites SEK 60 000:- / single events SEK 11 000:- / single entry Höljes 16 000:- + 6% tax

Notification to the individual competitions are accepted on the basis of space.

Championship fee will be invoiced by RX Promotion AB and must be paid latestly 30th of april

Enter the invoice recipients

Name *

 

Address *

 

Post code *

 

Town / Country *

 

Organization no.*

 

VAT no.*

 

required fields *

 

Team

 

 

 

Name

 

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

Paddock informations

 

 

 

Total surface for service vehicle + service tent

width *

 

meter

length *

 

meter

Additional informations

 

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

 

 

 

 

 

 

Extra power electricity (ORDER)

 

 

 

 

 

 

400 V 16 A

quantity

 

 

 

 

 

 

 

400 V 32 A

quantity

 

 

 

 

 

 

 

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

Power electricity which is not be 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 TO THE PRIVACY POLICY ALL SPORTING, COMMERCIAL AND PADDOCK REGULATIONS *

Regulations RallyX Nordic 2019

required fields *