Entry Form CEZ
Date of Event: 18.-19. May 2019.
Adress: Jarnevići 2, 47272 Ribnik, CROATIA, LOCATION GPS: E 15° 23.64864' N 45° 44.1741'
This Entry Form must be filled latest Friday 11.05.2019. 24:00 hours.
Original of this Entry Form will signed by rider on the administrative check.
On the administrative check rider must:
- present rider's licence, medical control, starting permission from national federation
- pay entry fee
CLUB or TEAM DATA
ENTRANT (NAME OF THE CLUB or TEAM)/ bewerber / natjecatelj (ime kluba ili teama)
DRIVER'S DATA / fahrer / vozač
Name & Surname
Driver's licence number
Driver's e-mail adress
Driver's mobile phone number
Rider's date of birth
Junior YES or NO
Driver's home adress, street, post number, city
STATEMENTS OF THE CAR
Super Buggy (over 1600 up to 4000 cc)
Buggy 1600 (up to 1600 cc)
Junior Buggy (up to 600 cc)
Touring Autocross + Group H
Touring Autocross 1600
Divizija Prvenstvo Hrvatske i Prvenstvo Slovenije (Samo za CRO i SLO vozače)
Brand of the vehicle
Type of vehicle
Cylinder capacity (ccm)
BILLING INFORMATIONS (FOR THE INVOICE)
Name & Surname, or Name of the Company, or Name of the Club
Billing adress, street, post number, city, country
TERMS AND REGULATIONS, Memorijal Josip Pilat, Ribnik 2019
Latest Friday 11.05.2019. any driver can enter to Memorijal Josip Pilat, Ribnik 2019 CEZ Championship race. In case of non-participating a meeting, rider must send an excuse. By handing over this entry-form the undersigned declares herewith to comply with the FIA International Sporting Code, the national Sporting Code of the National Federation as well as the FIA CEZ Sporting and Technical regulation for season 2019, this Supplementary Regulations and to respect them strictly.
I accept the liability waiver of the Supplementary Regulations explicitly and approvingly and agree in all points as well as with all other articles of the Supplementary Regulations I am provided with the complete text of the Supplementary
Regulations.Participants Responsibility et Liability
The participants (entrants, drivers, passengers, owners and owner-drivers of vehicles) take part in the event at their own risk. They bear the sole responsibility regarding civil and penal codes for damages caused by them or the vehicle in their use of so far as no liability exemption has been stipulated in compliance with the supplementary regulations of the meeting. If the driver, himself, is neither the owner nor the owner-driver of the vehicle used by him during the competition, he releases those persons listed in the following liability waiver from all claims by the owner and the owner-driver of the vehicle or submits, together with the entry form, a corresponding waiver from the owner or the owner-driver of the vehicle.
b) Liability Waiver
By submitting the entry form, the participants (entrants, drivers, passengers, owners and owner-drivers of vehicles) waive all rights to legal action and recourse for any accident or damage incurred in conjuction with the event against
- the FIA, the FIA CEZ, the National Federation, Promoter, Organizer(s) of the race and their
presidents, members employees and officials member-club of the National federation and
- organizer/promoter, his/their representatives, stewards and assistants;
- the owner(s) of the property used for the event including structures and installations on it, the administration of the
circuit used for the event, its representatives and assistants;
- the participants and their attendants as well as against his/their own assistants in so far as a race or special tests
for attaining high-speeds or best times are concerned;
- authorities, race services and any other organization or corporate or natural bodies involved in the organization of the
event, in so far as the accident or damage did not occur through intent or gross negligence. This agreement will take
effect for all parties involved with the submission of the entry form to the organizer.
DATA PROTECTION PERMISSION
Organiser of the race hereby informs Applicant that for the purpose of this document any personal details given may be stored and treated in a person all data file pertaining to General Data Protection Regulation – GDPR (EU) 2016/679. The data are required to establish that they meet the requisites set out for the purpose of this document. They will be treated strictly for said purposes, also through automatic procedures and will not be disclosed to any third party, without prejudice to the right to verify their authenticity with the competent authorities.
Applicant gives his permission to Organiser at the race, to use all data in:
- Personal communication with Applicant
- Administrative check of Applicant
- Technical check of Applicant’s car
- All financial transactions
- Automatic data recording
- Recording with CCTV
- Recording for TV and Internet broadcast
- Medical treatment of Applicant
- Automatic data recording for timing
- Publishing results on the event on paper and screens
- Publishing live results during the event and PDF results after the event on internet
- Publishing live results during TV broadcast on TV and internet
Furthermore, the Applicant has been informed and acknowledges that holds the right to access his/her information, to correct it and/or to request the cancellation of the before mentioned file.
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