Skip to content
Home
Gallery
Disciplin’s
Rally
Hill Climb
Circuit
Contact
Menu
Home
Gallery
Disciplin’s
Rally
Hill Climb
Circuit
Contact
Entery
Entry form
Closing date for entries: 13.07.2022
Competitors data:
Klub / Club
Vozac / Driver
Suvozac / Co-Driver
Klub / Club
Ime ( Vozaca ) / Name ( Driver )
Ime ( Suvozaca ) / Name ( Co-Driver )
Prezime ( Vozaca ) / Last Name ( Driver )
Prezime ( Suvozaca ) / Last Name ( Co-Driver )
Datum Rodjenja ( Vozaca ) / Date of Birth (Driver)
Datum Rodjenja ( Suvozaca ) / Date of Birth ( Co-Driver )
Nacionalnost ( Vozac ) / Nationality (Driver)
Nacionalnost ( Suvozac ) / Nationality ( Co-Driver )
Adresa / Address
Andresa ( Vozaca ) / Address ( Driver )
Adresa ( Suvozaca ) / Address ( Co-Driver )
Potvrda Prijave / Entry confirmation
Potvrda Prijave ( Vozaca ) / Entry confirmation ( Driver )
Potvrda Prijave ( Suvozaca ) / Entry confirmation ( Co-Driver )
Telefon / Phone
Telefon ( Vozaca ) / Phone ( Driver )
Telefon ( Suvozaca ) / Phone ( Co-Driver )
Mobilni Telefon / Mobile Phone
Mobilni Telefon ( Vozaca ) / Mobile Phone ( Driver )
Mobilni Telefon ( Suvozaca ) / Mobile Phone ( Co-Driver )
Email
Email ( Vozaca ) / Email ( Driver )
Email ( Suvozaca ) / Email ( Co-Driver )
Broj Licence / License Number
Broj Licence ( Vozaca ) / License Number ( Driver )
Broj Licence ( Suvozaca ) / License Number ( Co-Driver )
Licenca Izdata od / License Issued by
Licenca Izdata od ( Vozac ) / License Issued by ( Driver )
Licenca Izdata od ( Suvozac ) / License Issued by ( Co-Driver )
Broj Vozacke Dozvole ( Vozaca ) / Driver License Number
Broj Vozacke Dozvole ( Suvozaca ) / Co-Driver License Number
Izdata vozacka u Drzavi ( Vozac ) / Issued driver license in the State
Izdata vozacka u Drzavi ( Suvozaca ) / Issued Co-Driver license in the State
Podaci o vozilu
Marka / Brand
Registarski Broj / Registration number
Model
Zapremina CCM / Cubic cappacity ccm
Godina Proizvodnje / Year of manufacture
Broj Sasije / Body No.
Grupa - Klasa / Group- Class
Broj Motora / Engine No.
Broj Homologacije / Homologation No.
Boja / Predominant colour
Drzava gde je registrovano / Country of registration
Broj tehnicke knjizice / Tech. Passport No.
.
DA / YES
NE / NO
Prihvatam reklame organizatora / Organisers' proposed advertising accepted
PRIORITET / SEEDING INFORMATION
Vozac / First driver:
Grupa - Klasa / Group - Class
Vozilo / Car
.
DA / YES
NE / NO
FIA prioritet A / FIA priority A
.
DA / YES
NE / NO
FIA prioritet iz prosle sezone / Previous FIA seed:
Ako da, godinu / If Yes, year
.
DA / YES
NE / NO
Nacionalni Prioritet / National seed
.
DA / YES
NE / NO
Nacionalni Prioritet iz prosle sezone / National Priority from last season
Ako da, godinu / If Yes, year
.
DA / YES
NE / NO
Drzavni Sampion / State Champion
Ako da, godinu / If Yes, year
DA
PRIZNANJE I SPORAZUM Svojim potpisom izjavljujem da su sve informacije sadržane u obrascu za prijavu tačne i da prihvatam i da se u potpunosti slažem sa uslovima gore navedenog obeštećenja i da prihvatam sve uslove i odredbe koji se odnose na moje učešće u ovom događaju
ACKNOWLEDGMENT AND AGREEMENT By my signature I declare that all the information contained on the entry form is correct and that I acknowledge and agree in full to the terms of the above indemnity and that I accept all the terms and conditions relating to my participation in this event.
Posalji Prijavu / Send form
Please do not fill in this field.
