The 100 Miles 2023 - Registration form

The 100 Miles 2023 - Registration form

Welcome to the registration form for the 'The 100 Miles' rally.
Type of client*
Name driver*

PrefixFirst NameLast Name
Driver contact details*

Street + housenumber

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Driver e-mail*
example@example.com
Driver phone number*
example: +32475123456
Driver - size of jacket
Driver - dietary restrictions*
Name navigator*

PrefixFirst NameLast Name
Navigator contact details*

Street + housenumber

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Navigator e-mail*
example@example.com
Navigator phone number*
example: +32475123456
Navigator - size of jacket*
Navigator - dietary restrictions*

Only for business entry's, if private please click next
Company address, used for invoice, is ...
Company Name
VAT number
Company Address

Street + housenumber

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Make of car*
Model & version*
Date of manufacturing*

DayMonthYear
Date
Engine capacity (cc)*
Please upload 2 pictures of the vehicle

Cancelof

Select your package

Please select and customise your entry to The 100 Miles of Bruges here
prevnext( X )
Registration + Hotel- Registration to The 100 Miles of Bruges for 1 car - Standard room in Weinebrugge Hotel - Dinner for driver and co-driver - Warming stops along the way - 2 Tickets to Prewar Days 2023 (valid 1 day) - Tote bag including roadbook and extra's - 2 exclusive The 100 Miles jackets - Rally plate - Increadible experience
€675.00



Registration without hotel- Registration to The 100 Miles of Bruges for 1 car - Dinner for driver and co-driver - Warming stops along the way - 2 Tickets to Prewar Days 2023 (valid 1 day) - Tote bag including roadbook and extra's - 2 exclusive The 100 Miles jackets - Rally plate - Increadible experience
€525.00



Extra passenger- Dinner for extra passenger - Warming stops along the way - 1 Ticket to Prewar Days 2023 (valid 1 day) - Incredible experience
€150.00 Quantity



Extra standard hotel room- Standard room for 2 people
€150.00 Quantity



Sponsor of The 100 Miles - Registration to The 100 Miles of Bruges for 1 car - Superior room in Weinebrugge Hotel - Logo's in the roadbook - Possibility to add promotional material to the tote bag - Logo on Website with link to your website - Dinner for driver and co-driver - Warming stops along the way - 2 Tickets to Prewar Days 2023 (valid 1 day) - Tote bag including roadbook and extra's - 2 exclusive The 100 Miles jackets - Rally plate - Increadible experience
€850.00



Partner of The 100 Miles - Registration to The 100 Miles of Bruges for 2 car - 2x Superior room in Weinebrugge Hotel - Logo's in the roadbook and rally sticker - Possibility to add promotional material to the tote bag - Logo on Website with link to your website - Dinner for driver and co-driver - Warming stops along the way - 4 Tickets to Prewar Days 2023 (valid 1 day) - Tote bag including roadbook and extra's - 4 exclusive The 100 Miles jackets - Rally plates - Increadible experience
€2,000.00



Total

€0.00
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The 100 Miles 2023 - Registration form

Only for business entry's, if private please click next

Select your package