REGISTRATION 100 Series 2019
All fields marked with * are mandatory
RACES
Chose your race(s)
*
TERLAEMEN200
MAGNY-COURS200
ASSEN200
SPA200
ZOLDER200
FRANCO200
CAR
Competition Car Number
*
Mark
*
Type
*
Model Year (YYYY)
*
Displacement (cc)
*
Fuel Type
*
Petrol
Diesel
Turbo
*
Yes
No
Compressor
*
Yes
No
LICENCES
Entrant Licence Nr
*
TEAM MANAGER
Identity
*
First Name
Last name
Phone
*
Email
*
DRIVERS ( From 1 to 5 )
Pilot 1
Nationality
*
Identity
*
First name
Last name
Birthday (YYYY/MM/DD)
*
Licence Type and Degree
*
Licence Number
Phone
Email
*
Federation authorization if participating in a foreign event
Select File to Upload
Choose your document
Pilot 2
Nationality
Identity
First name
Last name
Birthday (YYYY/MM/DD)
Licence Type and Degree : example : International C
Licence Number
Phone
Email
If required : Authorization of your Federation
Select File to Upload
Choose your file
Pilot 3
Nationality
Identity
First name
Last name
Birthday (YYYY/MM/DD)
Licence Type and Degree : example : International C
Licence Number
Phone
Email
If required : Authorization of your Federation
Select File to Upload
Choose your file
Pilot 4
Nationality
Identity
First name
Last name
Birthday (YYYY/MM/DD)
Licence Type and Degree : example : International C
Licence Number
Phone
Email
If required : Authorization of your Federation
Select File to Upload
Choosee your file
Pilot 5
Nationality
Identity
First name
Last name
Birthday (YYYY/MM/DD)
Licence Type and Degree : example : International C
Licence Number
Phone
Email
If required : Authorization of your Federation
Select File to Upload
Choose your file
PAYMENT
Identity of Payer of this registration
*
First name
Last name
Payment Method
*
Payment on Bank account
Payment on the place of event
BNP PARIBAS FORTIS : IBAN : BE24 0017 3518 8338 - BIC : GEBABEBB