Online Registration

DRIVER

Name

Surname

Address

Zip Code

City

Country

Phone

Fax

Email

Driving License:

Exp. date: (dd/mm/yyyy)

Issued by

On the (dd/mm/yyyy)

Sex
 F M

Size
 S M L XL

Food intolerance

CO-DRIVER

Name

Surname

Sex F M

Size  S M L XL

Food intolerance

CAR

Brand

Model

Colour

Capacity

Year

Registration number

Asi Registration n°

Fiva Passport n°

Issued (dd/mm/yyyy)

Insurance

Policy No

Expiring: (dd/mm/yyyy)

F.I.V.A. Passport n°:

REGISTRATION FEE:

Cars pre '65

 2 person included 3 nights in Hotel€ 1500 1 person included 3 nights in Hotel € 1000 2 person without accomodation € 900 1 person without accomodation € 600 1 Guest of a Crew with 3 nights in hotel € 1000 1 Guest of a Crew without accomodation € 600

Roadster cars of the 20’s:

 For information and fees please select

HOSPITALITY

HOTEL LA MERIDIANA (****)
Via del Discobolo, 42 - 06132 Perugia

T. (+39) 075 517 2347
info.meridiana@lindberghotels.it
www.lameridiana.it

 Twin bed room Double room Single room

PAYMENTS

 Bank transfer

I AGREE TO RULE AND TERMS AND CONDITIONS

Camep, the organizers and the volunteers of the event decline any responsability for any damages o vehicles, participans, guests, third parties or can owners who are to attend directly or indirectly, before, during or afer the event. Camep, the organizers and the volunteers can’t be legally prosecuted. By applying through the application form, participants declare the correctness and accuracy of the information provided by Camep. The organizers can sanction any negligence or any failure to comply with the regulations, any unsportsmanlike conduct or any violation ofrules and regulations with the disqualification from the event, without refunding of the incurred expenses. By signing he application form, the participant engages in respecting without any reserve the above mentioned conditions regulated by the Italian Law. The competent court is Perugia.