JULY 4th & 5th @ MONS

JULY 4th & 5th @ MONS

=> 4 races @ Grand Large de MONS # MONSNAUTEAM
Team

Team NameTeam Number
Discipline
Choose your type of Watercraft
Aquabike Class
ProCat Class
ProCat : The entry fee is € 100 per person per raceweekend ( = 4 races)

To be payed on our ING account : BE76 3930 0713 9895

The price per person after June 21st will be € 125 !!!

this includes safety people and rescue on water
Aquabike : The entry fee is € 100 per person per raceweekend ( = 4 races)

To be payed on our ING account : BE76 3930 0713 9895

The price per person after June 21st will be € 125 !!!

this includes safety people and rescue on water
Powerboat : The entry fee is € 200 per person per raceweekend

this includes safety people and rescue on water
Watercraft Builder
The brand of your Watercraft
Watercraft Type
The model of your Watercraft
Engine Builder
The brand of your engine
Engine hp
The Horsepower of your Engine
Insurance Company
Type the name of the company of your Insurance
Insurance Policy
Type the number of your Insurance Policy
Pilot Name

First NameLast Name
Pilot Date of Birth

DagMaandJaar
Datum
Co-Pilot Name

First NameLast Name
Co-Pilot Date of Birth

DagMaandJaar
Datum
Emergency Contact

First NameLast Name
Address

Street Address

Adresregel 2

CityProvincie

Postal/Zip codeCountry
Email Address
example@example.com
Phone Number

Country CodePhone Number
Signature
Should be Empty: