APPLICATION FORM "Super - Veteran 2012" Lublin 2012 meeting May 19th, Lublin, Poland
Please send on-line this completed application form until the 13th may 2012.
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Participant
Name *
Surname *
Date of birth *
Address *
City *
Postal code *
Phone
E-mail
Motorcycle
Brand *
Model *
Year of production (yyyy) *
Engine type *
Capacity (cm3) *
Engine power (horsepower) *
Sidecar *
Remarks
Competitions
Competitions
Motorcycle Rally Attend
ATTENTION!
Organizer will not make a hotel reservation for You. Please book and pay hotel on Your own. Our recommendation for accommodation: Malibu Resort, Krężnica Jara 131a, 20-515 Lublin, www.malibu.lublin.pl  which is the event location.
Apart from submitting the above on-line application form, please contact personally the Race Office on the day of race, 19th May 2012, since 8.00, before the race begins.
Number of persons *
Motorcycle Parking *
Statement
I hereby state that I am acquainted with and obliged to observe the contents of the Regulation of the Race and the regulations concerning the ban to use anabolic steroids and substances mentioned in the regulation of the medical service of the motor competition. In relation to the acceptance of my application to participate in the race I am obliged not to institute any legal proceedings and any other claims against the organizers, official workers, representatives and agents to return costs and expanses or in case of my death and injuries received by me, irrespective of the fact it results from the application to participate in the race.
I hereby state that if I suffered from any permanent or temporary ailments which may imply on the way of automobile control at the moment of the race commencement, I would not participate in the competition and I would report this to the Race Ofice, which is confirmed by my signature.
I hereby state that in case of any accident or collision during the race or trainings included in the detailed regulation of the competition caused unintentionally or caused because of that accidents or collision any damages I am obliged not to sue or take legal actions against: GKSM PZM, Club, Competition organizers, Referees and their assistants, Participants of races and trainings, Organizer’s employees, Other people involved in organizing the competition.
I accept Super - Veteran Lublin 2012 regulations.
I hereby authorize Organizer to process my personal data included in my application form for the needs of the registration process (in accordance to the Personal Data Protection Act 29.08.1997 no 133 position 883).
I accept this Statement *
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