Registration Alpe Adria 15.-17. 08. 2014

Meno a Priezvisko / Name and Surname (povinné - required)

Ulica / Street (povinné - required)

Mesto / City (povinné - required)

PSČ / Postal code (povinné - required)

Štát / State (povinné - required)

Národnosť / Nationality (povinné - required)

Materská federacia / FMN (povinné - required)

Dátum narodenia / Birth date (povinné - required)

Telefónny kontakt / Telephone (povinné - required)

E-mail (povinné - required)

Štartovné číslo / Start number (povinné - required)

Názov tímu / Team name

Číslo licencie / Licence number

Kubatúra / trieda motocykla / Motorbike class (povinné - required)
 125SP - 180 € Moto3 - 180 € STK600 - 290 € SSP - 290 € Moto2 - 290 € STK1000 - 290 € SBK - 290 €

Typ motocykla / Motorbike type (povinné - required)

Používam pneumatiky - značka (povinné)
Type of tires - manufacturer (required)

ŠPZ osobný automobil / Car plate number

ŠPZ kamión - obytný automobil / Truck - motor home plate number

Rezervácia boxu / Box reservation
(poznámka: box sa platí priamo na podujatí)
(note: box will be paid on the day of event)
 Áno - Yes Nie - No

Poznámka / Note

By handing over this entry form the rider declares herewith to comply the international Sporting Code of the FIM / UEM, the national Sporting Code of the OSK as well as the Supplementary Regulations and to respect them strictly. l accept the liability waiver of the eS.R.f explicitly and approvingly and agree in all points as well as with another articles of the S.R. I am provided with the complete text of the S.R.

By handing over this entry form the rider agrees under the law of personal data protection nr. 428/2002, ˜ 20 of Law code, to provide Slovakia Racing agency with the approval to process the personal data included in the entry form for the purpose of internal database. The approval is given for an undefined time period with the possibility of written cancellation.