(*) required field
|Class seniority vehicle
A (<1904)B (<1918)C (<1930)D ('31-'45)E ('46-'60)F ('61-'70)G('71-'96)
Note: (Please write any special request, like food allergies, or others and we will do our best to meet your needs)
The entry form must be accompanied by the payment of the amount of Euro 340,00 to be received before March 6, 2016. From 7 to 25 March 2016 the amount is Euro 390,00. If the number of 100 entries is exceeded , we will open a waiting list in order to evaluate, from an organizational perspective, if it is possible to extend the entry to as many participants as practical. But in case it was not possible to accommodate all requests, entry fees will be refunded for those whose entry was received latest. The fee is for teams of two people and include lunch and dinner on Saturday 2 April , lunch of Sunday, April 3, 2016 and the free mechanical assistance along the entire route for both days, excluding any spare parts and consumables, provided by the garage Autoelite and Automaniabo, specialist in classic cars. Overnight accommodation is NOT included and is the responsibility of the entrant.
The payment must be made by bank transfer; on the account of Scuderia Automobilistica Modena Historica to the bank Banco Pop. Soc. Cooperativa - BSGSP (agency of Maranello - MO) - IBAN: IT 43 M 05034 66820 000000013284 - Swift code: BAPPIT21434
Send copy of the bank transfer of Euro
by email a firstname.lastname@example.org
or by Fax to +39 0536-920048
REGULATION AND RESPONSABILITY
Acceptance of Rules and Release of Liability
Entrant's declare for themselves and their co-driver to accept unreservedly the program and the rules of the event (available on request) recorded in calendar ASIFED-FIVA, to comply with all regulatory requirements and recognize the relevance of the Organizing Committee as a single judge who’s decision is final in all matters regarding the event. Further acknowledges and agrees that the application form will be subject to approval by the Organizing Committee in its sole discretion and is valid only after payment of the registration fee.
With the request for participation the entrant indemnifies the organizing committee from any liability for any theft, loss or partial damage suffered or caused to themselves or others, to property and persons.
*Yes, I agree to the regulation in its entirety, and to absolve the organization from any liability.
Art. 23 D.lgs. n.196 of 30 June 2003
A copy will be sent to you for your reference.