Piešťanské Zlaté stuhy 2019

Electronic Application

Car:

Trade mark (You can't leave this empty.)

Type, model (You can't leave this empty.)

Year of production (You can't leave this empty.)

Number / volume of cylinders (cm3) (You can't leave this empty.)

Valve train and performance (hp) (You can't leave this empty.)

Max. speed (km/h) (You can't leave this empty.)

Weight (kg) (You can't leave this empty.)

Consumption (l/100km) (You can't leave this empty.)

Curiosity about the vehicle, its history (You can't leave this empty.)

Car Photography (You can't leave this empty.)

Driver:

Name (You can't leave this empty.)

Surname (You can't leave this empty.)

Born (You can't leave this empty.)

Address (You can't leave this empty.)

Email (You can't leave this empty.)

Phone (You can't leave this empty.)

Fax

Co-driver:

Co-driver name

Co-driver surname

Additional participants:

Additional participant (1.)

Additional participant (2.)

Additional participant (3.)

Children under 10 years of age:

Child under 10 years of age (1.)

Child under 10 years of age (2.)

Child under 10 years of age (3.)

Accommodation:

NEW - Hotel Magnólia **** (2 persons in a double room at the cost of the organizer)Thermia Palace ***** (at own expenses)Balnea Esplanade **** (at own expenses)Balnea Grand *** (at own expenses)

Number of persons

I declare and agree that I will not claim compensation from the organizers for any damage to the vehicle and other possible damages related to this competition, including possible injuries of the driver or passengers, and I also declare that the vehicle is duly insured. I will participate in the competition on my own risk and I will follow the instructions of the organizers.

During the presentation we will require a valid green card of the competing car.

I agree with the terms