Entry Form - Eifel Rallye Festival

Entry FormEntry for: ADAC EIFEL RALLYE FESTIVAL To be completeted by the organiser:Date: 25.-27.07.2013 START-No.Organiser: MSC Daun e. V. im ADAC Entry form received on:Trierer Straße 4, D - 54550 Daun Acceptance/rejection:Fax: +49(0) 65 92 / 4274 sent on:eMail : entry@eifel-rallye-festival.de Entry fee EUR received:Entry closing Date: 15.06.2013 Confirmation of entry:Entrant:Name:Adress:Driver:Surname:First name:Street adress:Postcode/City:Date of birth:Codriver:Surname:First name:Street adress:Postcode/City:Date of birth:Tel./Fax : Tel./Fax :Mobile : Mobile :E-Mail :E-Mail:Please send all documents to (if no indication, then driver's adress will be used) Driver CodriverCar details:Make: Original ReplicaModel:Group/class:Year of manifacture:Power/Engine capacity:Homologation No.:History of the car:Registration No.:Country of registration:Insurer:Insurance No.:Chassis No.:Slowly Sideways ClassificationTo be completed by the organiser!OriginalSlo3Slo1NationalSlo2OtherFor the classification of the car please include current pictures (exterior, interior, etc.) when submitting the entry form.With the submisssion the entrant declares that the pictures are free of copyright and may be published in the eventprogramme, on the website and the facebook presence of the Eifel Rallye FestivalResponsable for the classification of the rally cars is, according to Article 2 of the event regulations,Mister Reinhard Klein, Slowly Sideways, Köln.Please provide the following documents when signing on: To be completed by the organiser!Car registration: Driving licence (driver): Proof of insurance:Disclaimer: Driving licence (codriver): Agrrem. legal represent.(minors):The entry fee of 400,00 EURO is to be paid within 14 days after the confirmation of entry!The contract between the organiser and the entrant, is only concluded once the entry fee has arrived in the organiser's accountand the organiser has confirmed the entry.

Please tick appropriate box!XIt is confirmed that the driver entrant is the owner of the rally car to be used.Entrant or driver is not the owner of the rally car to be used. The car owner submits the disclaimer printed on this form.In the case of non applicable indications, the entrant/driver release the group of persons specified in the disclaimer from any claims of the car owner, with the exception ofdamages arising from life injury, from physical injury or from health injury caused by a deliberate or negligent breach of duty – including a legal representative or an agent of thegroup of persons for which the liability renunciation has been declared – and with the exception of other damages arising out of a deliberate or negligent breach of duty –including a legal representative or an agent of the group of persons for which the liability renunciation has been declared.In the case of claims against the other participants (entrants, drivers, passengers), their assistants, the owners and proprietors of the other cars, the own entrant, driver/s,passenger/s and own assistants they agree to save harmless and to keep indemnified from and against all actions, claims and demands arising out of or in connection with thespecial stage/s to achieve highest speed or shortest driving time and the corresponding tests and in the case of claims against the other persons and bodies on damages whicharise in connection with the event as a whole.General contractual declaration of entrant, driver and co-driverEntrant, driver and co-driver must accept facts in the person or the conduct of a team member (entrant, driver, co-driver, mechanic) touching the contractual relationship withthe organiser or motivating a claim for damages counting for or against them. Entrant, driver and co-driver are jointly and severely liable for all obligations resulting from theentry contract.Entrant/driver/co-driver confirm that the statements made on the entry form are correct and complete, that driver/co-driver meet the requirements of the demonstration runs,that the car complies in all points with the technical regulations of the event, that all parts of the car may be checked by the scrutineers and that they will use the car at thecorresponding event in a perfect technical and optical condition.Entrant/driver/co-driver confirm that the car is registered for public traffic and insured and the insurance rate is paid. Corresponding confirmation have to be added to the entryform and must be presented at administrative check! - also see page 1 of the entry form.With their signature, they furthermore confirm that they have studied the the "Kurzausschreibung" and participant information (can be found and downloaded on organiser'shompage) and will respect them.The participants take part in the event at their own risk. They carry sole civil and criminal responsibility for all damages caused by them or the car used by them, as far as noliability renunciation is agreed.With the submission of the entry, each entrant, driver, and co-driver agrees to save harmless and to keep indemnified from and against all actions, claims and demands arisingout of or in connection with the participants of the event:- the ADAC districts, the promoter/ organiser,- the organiser, their marshals, administrative authorities and any other person being involved in the organisation of the event,- the road construction authorities as far as any damage is caused by the condition of the roads used during the event- the agents, workers of all persons and posts mentioned above, with the exception of damages arising from life injury, from physical injury or from health injury caused by adeliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liability renunciation has been declared – and with theexception of other damages arising out of a deliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liabilityrenunciation has been declared; Against- the other participants (entrants, driver/s, co-driver/s), their assistants, the owners and proprietors of the other cars,- the own entrant, driver/s, co-driver/s (diverging special agreements between driver/s and co-driver/s have priority) and own assistantsthey agree to save harmless and to keep indemnified from and against all actions, claims and demands arising out of or in connection with the special stages and thecorresponding tests, with the exception of damages arising from life injury, from physical injury or from health injury caused by a deliberate or negligent breach of duty –including a legal representative or an agent of the group of persons for which the liability renunciation has been declared – and with the exception of other damages arising outof a deliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liability renunciation has been declared.The disclaimer will take effect against all parties involved by sending the entry form.The liability renunciation refers to any claims for whatever reason, in particular for liability claims arising out of contractual as well as non-contractual responsibility and to anyclaims arising out of unauthorised actions. Tacit liability renunciations are not affected by the above liability renunciation provision.In the case of a breach occurring or ascertained during the event or in the case of a health problem which might temporarily or permanently put into question the fitness for theparticipation in automobile sport events, the undersigned releases all treating doctors from their legal requirement concerning confidential medical information towards the keyofficials on duty at the event (chief medical officer, clerk of the course, stewards) – under consideration of the safety risk which might eventually also result for third parties.Place, date Entrant’s signature – if not identical – Signature driver / co-driverDisclaimer of the car owner(Only required if entrant, driver or co-driver is not the owner of the rally car to be used, see top of the page)I agree with the participation of the car specified on the entry form in the event and to save harmless and to keep indemnified from and against all actions, claims and demandsarising out of or in connection with the participants of the event:- the ADAC districts, the promoter/ organiser,- the organiser, their marshals, administrative authorities and any other person being involved in the organisation of the event,- the road construction authorities as far as any damage is caused by the condition of the roads used during the event- the agents, workers of all persons and posts mentioned above, with the exception of damages arising from life injury, from physical injury or from health injury caused by adeliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liability renunciation has been declared – and with theexception of other damages arising out of a deliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liabilityrenunciation has been declared; Against- the entrants, driver/s, co-driver/s, assistants, owners and proprietors of the other cars, the assistants of the participant/s specified on the entry form and the other participantsas well as against the entrant/s, driver/s, co-driver/s of the car made available by myself (diverging special agreements between owners, entrants, driver/s, co-driver/s havepriority)I agree to save harmless and to keep indemnified from and against all actions, claims and demands arising out of or in connection with the special stages and thecorresponding tests, with the exception of damages arising from life injury, from physical injury or from health injury caused by a deliberate or negligent breach of duty –including a legal representative or an agent of the group of persons for which the liability renunciation has been declared – and with the exception of other damages arising outof a deliberate or negligent breach of duty – including a legal representative or an agent of the group of persons for which the liability renunciation has been declared.The liability renunciation refers to any claims for whatever reason, in particular for liability claims arising out of contractual as well as non-contractual responsibility and to anyclaims arising out of unauthorised actions. Tacit liability renunciations are not affected by the above liability renunciation provision.Place, date Signature of the car owner Owner's name and adress in block letters