Appendix ¹1
Application form
Participation in IX-international off-road raid «LADOGA’2003» (4 - 12 of June 2005)
GROUP (mark necessary) «SPORT» «PROTO-SPORT» «RAID» «TOURISM» «ATV»
TR2 TR3
Country: Club:_______________________________
Vehicle model:____________________________________________ _____
Driver's name:_____________________________________________ _________
Date of born «____» ______________ 19 ã.
Co-Pilot name:_____________________________________________ _________
Date of born «____» ______________ 19 ã.
Post address for contact (full):
Phone number: work.:__________________ home.:__________________
E-mail:_____________________________________________ _____
I am acquainted with the Regulations of competitions and I oblige to follow it.
I confirm, that the equipment of my vehicle fully complies with requirements of the Regulations.
I also oblige to not show what claims to the Organizer of competitions in a case:
- receptions of traumas by me personally or members of my crew;
- damages of my vehicle;
- drawings of damage to me or my vehicle the third parties
write: "Is acquainted and agree" Signature
Driver
Co-Driver
Date: «______» 2004 year
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