Competition Category Type of crew Obligatory composition of crew
International PHYS STANDARD PHYS-ST 1 Physician+2 Paramedics
       

 

 

 

For guests (accompanying persons, photographers etc.) please use registration form for other participants.

Please fill in, items marked bold are mandatory!

Organization:
Organization ID:
Address:
Street:
City:
ZIP:
Country: Please use international vehicle registration codes, e. g. A, PL, USA, TK...
Contact person:
First name:
Middle name:
Family name:
Cellphone:
E-mail:

Physician:

Title First name Middle name Family name Title
Gender: Date of birth (MM/DD/YYYY): //
Passport/ID Card No.:
Home address:
Street:
City:
ZIP:
Country: Please use international vehicle registration codes, e. g. A, PL, USA, TK...
Cellphone:
E-mail:
Select the highest completed course:
Arrival: Departure:

Paramedic 1:

Title First name Middle name Family name Title
Gender: Date of birth (MM/DD/YYYY): //
Passport/ID Card No.:
Home address:
Street:
City:
ZIP:
Country: Please use international vehicle registration codes, e. g. A, PL, USA, TK...
Cellphone:
E-mail:
Select the highest completed course:
Arrival: Departure:

Paramedic 2:

Title First name Middle name Family name Title
Gender: Date of birth (MM/DD/YYYY): //
Passport/ID Card No.:
Home address:
Street:
City:
ZIP:
Country: Please use international vehicle registration codes, e. g. A, PL, USA, TK...
Cellphone:
E-mail:
Select the highest completed course:
Arrival: Departure:

Driver (if is non-competing crew member):

Title First name Middle name Family name Title
Gender: Date of birth (MM/DD/YYYY): //
Passport/ID Card No.:
Home address:
Street:
City:
ZIP:
Country: Please use international vehicle registration codes, e. g. A, PL, USA, TK...
Cellphone:
E-mail:
Select the highest completed course:
Arrival: Departure:

Car:

Type:
License plate:
Year of production:


Acceptance:

We declare that we have read and understand the conditions and rules of the Rallye Rejviz.
We agree with the collection of personal data for organisation of the Rallye Rejviz.


Please fill control code from picture:

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We will send confirmation of registration and proforma invoice for the payment of participation fees to e-mail of the contact person as soon as possible.
Automatic confirmation mail will be sent in few moments. Please check your mailbox and spam folder, contact us if you do not receive confirmation e-mail within one hour.