Entryform (GB) – Full Throttle Internationals, BRUSTEM – 25/26 september 2010

IMPORTANT:

Make sure the (digital) entryform (see below) AND the payment is on our account before the 15th of September.

Attention!!
Payments are due at the 15th of September. Penalties for late entry or payment is 100.- euro extra!

The attendance-fee for the 2010 races on the airstrip in Brustem will be 150.- Euro per event, and a yearly obligatory membership of Dragrace club eXplosion of 50.- Euro. This includes the free use of electricity on site during the events and wristbands driver, 2 mechanics and 2 visitors, so 5 in total.
He or she who doesn’t want to be a member of eXplosion will pay an entry-fee of 200.- euro per event.

Pricing for double registration for 2 raceclasses per event, is as follows:
- Same person, same vehicle: Additional 150.- Euro (No extra electric bill, but also no extra wristbands)
- Same person, different vehicle in same or different class: Additional 200.- Euro (Just a double entry fee, will include 5 extra wristbands)
- Junior Dragster and Junior Drag Bike: EUR 75,- per event, but with limited wristbands; 1 for the driver and 1 for the helper.

An eventlicence is only valid for the followingclasses:
- Bikes: Junior Drag Bikes, Street Bikes (ET), Street Bike and Ultimate Street Bikes.
- Cars: Junior Dragsters, Sportsman ET and Super Street Cars.
Only available for Dutch passport-holders.

All Drachten races are three day events!! Brustem 2 days.

Bankaccount:
Fortis Bank Nederland NV
Accountnumber 81.92.00.891
IBAN: NL52 FTSB 0819200891
BIC: FTSBNL2R
In the name of Dragrace Vereniging eXplosion, De Bilt, The Netherlands
Extra costs regarding payment are for the driver!

Clearly mention name, address and starting number.

We would really like you to pre-subscribe so we can make the starting lists in advance. About two weeks before the race-event we will send you an entry-confirmation. Take this with you to Drachten to avoid long waitingtimes at the gate. There’s NO possibility to enroll at the gate!

Entryform Full Throttle Internationals, BRUSTEM 2010

Select the eXplosion-event you would like to participate in:

Full Throttle Internationals, Brustem Belgium – 25/26 September

Starting License:

Yes, I have a Starting License. License number:

No I don’t have a Starting License and would like to buy an Event-starting license.
(45,- Euro for bikes and 30,- Euro for cars)*
Only possible for people with a Dutch Passport. *Prices subject to change.

Driverslicense number:

Personal information:

Name:

Surname:

Address:

Postal/Zip-code:

City:

Country:

Phone:

Cellphone:

Email address:

Date of birth:

Day – - Month – - – - – Year (xxxx)

Vehicle:

RacingClass:

When you would like to race in 2 different classes on the same event, select the second racingclass here:

Starting number:

Verhicle Make:

Type/Model:

Build year:

Vehicle nickname:

Engine size:

Number of cylinders:

Fuel type:

Best ET @ Speed:

If the total surface-area of your trailer and tent larger than 18m2 (about 193 sq.ft),
then please list it’s current length and width:

Special/Remarkable verhicle specifications

Sponsor(s):

Power-adders

Nitrous

Injection

Turbo

Blower

By submitting this entry-form the tenderer declares to accept and obey the instructions, conditions and decisions of the organiser and its officials, and to be aware of the standing Sprint- and Dragracing-regulations. Also he declares to exclude the organiser EXPLOSION, its employees, the KNMV and KNAF and its officials, as well as other competitors from claims in any way whatsoever and by all means. Teams, whose members are found intoxicated by alcohol or drugs in any way during qualifying or racing, are disqualified from the event immediately !