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Moto/Quad Application/Registration
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Required information.
Pilot sex:
*
Male
Female
Pilot surname:
*
Pilot first name:
*
Pilot address:
*
Pilot postal code:
Pilot city:
*
Pilot country:
*
Pilot e-mail:
*
Pilot work telephone:
*
Pilot mobile phone:
*
Pilot date of birth:
*
Pilot place of birth:
*
Pilot nationality:
*
Pilot blood group:
*
Pilot contact in case og emegency (surname + tel.):
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Pilot photo (max 100Kb)
Team:
Team contact.
Team tel.:
Team e-mail:
Vehicle brand:
*
Vehicle model:
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Vehicle license plate number:
*
Vehicle date of first license:
*
Vehicle serial number:
*
Vehicle group
*
Moto 0-450cc
Moto 451cc +
Quads 0-500cc
Quads 501cc +
Service car/s brand (if more than one = (Brand-1), (Brand-2)):
Service car/s model (if more than one = (Model-1), (Model-2)):
Service car/s registration plate (if more than one = (Number-1), (Number-2)):
Hover over the left image and enter the security code into the right textfield.
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ICCR 2010
PRESS - MEDIA
Regulations