Europe Rally 2022 - Registration Form

+39 347 3319139

camperclubuniverso@gmail.com

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Europe Rally 2022

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Registration Form

REGISTRATION FORM

59th Europe Rally from 2 to 6 june 2022
Larino – Molise – Italia

SEND BEFORE May 5, 2022

Special benefits for participants for bookings with bank transfer received by april 1, 2022

To avoid disappointment, due to the space available on the rally ground, it is recommended to register in advance and pay as soon as possible, without waiting for the scheduled registration deadline. You will be arranged in the order established by the management, considering the chronological order of the registration.

Sign up by sending us the registration form below.

Register by sending us the registration form below and then, to confirm, send the amount due within 5 days from the communication of acceptance of the registration request.

First Name ad Last Name*

First Last

Date of birth*

Day

Month

Year

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Nationality*

Club/association

CCI N°*

Is there another adult?*

yes

no

Name other adult*

First Last

Date of birth*

Day

Month

Year

Is there another adult?*

yes

no

Name other adult*

First Last

Date of birth*

Day

Month

Year

Is there a child between 12-17 years old?*

yes

no

Name of child 12-17*

First Last

Date of birth*

Day

Month

Year

Is there a child?*

yes

no

Name of the child*

First Last

Date of birth*

Day

Month

Year

E-mail (to receive confirmation)*

Enter Email Confirm Email

Phone number*

Book for:*

Tent

Roulotte

Camper

Lenght (cm)*

Vehicle plate*

Special Needs (Disabled)

Date of arrival:*

Date departure:*

REGISTRATION FEES

Go up! Complete the "Is there another adult?" Section. correctly. then come back here.

€170,00 a equipaggio (2 persone)

Number of crews (2 people)

Crew registration (2 people)

Number of crews (2 people)*

Please enter a number greater than or equal to 1.

Total

€110,00 a equipaggio (1 persona)

Number of unit (1 person)

Crew registration (1 person)

Number of unit (1 person)*

Please enter a number greater than or equal to 1.

Total

€60,00 adulto extra

Addittional adult

Number of people*

Please enter a number greater than or equal to 1.

Total

€30,00 children 12-17 years old

Children 12-17

Number of children (12-17)*

Please enter a number greater than or equal to 1.

Total

* FREE Children up to 11 years old

Total per registration

EXCURSIONS

N°1 LARINO - 01/06/2022
€ 13,00 p.p.

Excursion Nr1

Larino 01/06/2022

Number of people

Total excursion Nr°1

N°2 ISERNIA, FORNELLI and CASTELPETROSO - 02/06/2022
€ 42,00 p.p.

Excursion Nr2

Isernia, Fornelli e Castelpetroso 02/06/2022

Number of people

Total excursion Nr°2

N°3 LARINO - 02/06/2022
€ 13,00 p.p.

Excursion Nr3

Larino 02/06/2022

Number of people

Total excursion Nr°3

Nr°4 TERMOLI - 03/06/2022
€ 29,50 p.p.

Excursion Nr 4

Termoli 03/06/2022

Number of people

Total excursion Nr°4

Nr°5 LARINO - 03/06/2022
€ 13,00 p.p.

Excursion Nr. 5

Larino 03/06/2022

Number of people

Total excursion Nr°5

Nr°6 AGNONE - 04/06/2022
€ 44,00 p.p.

Excursion Nr 6

Agnone 04/06/2022

Number of people

Total excursion Nr°6

N°7 FROSOLONE - 04/06/2022
€ 33,00 p.p.

Excursion Nr 7

Frosolone 04/06/2022

Number of people

Total excursion Nr°7

N°8 FROSOLONE - 05/06/2022
€ 33,00 p.p.

Excursion Nr 8

Frosolone 05/06/2022

Number of people

Total excursion Nr°8

N°9 BOJANO and ALTILIA - 05/06/2022
€ 29,00 p.p.

Excursions Nr 9

Bojano e Altilia 05/06/2022

Number of people

Total excursion Nr°9

Total for excursions

TOTAL EUROPE RALLY and EXCURSIONS

Total per Europe Rally and excursions

The organizers reserve the right to modify the programs.

PAYMENT

Bonifico bancario a:

Nome:	BASILISCO PASQUALE
Banca:	POSTE ITALIANE
IBAN:	IT19I3608105138284412184427
SWIFT (BIC):	PPAYITR1XXX
Causale:	NOME e COGNOME per EUROPA RALLY 2022

Registration will be accepted only after the total amount has been credited to the organizer's account, to be made within 5 days from the communication of acceptance of the registration request.

Data d'iscrizone
25/06/2022

* The participants, with their free and voluntary participation in the program and in all activities and events, exempt the organizers expressly and in advance from any civil, criminal and administrative liability.

GDPR**

I consent to the processing of personal data

For renouncing to participate, justified and documented, by 22 May 2022 we will refund 90% of the amount paid. NO REFUNDS FOR COMMUNICATIONS RECEIVED AFTER MAY 22, 2022.

camperclubuniverso@gmail.com

© 2021 Camper Club Universo – Europa Rally 2022

+39 347 33 19 139

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