Registration

Please fill out this form only if you have never received our brochures before!

This is no nomination for the Seiberer-award-of-the-mountain. Registration for participation is only up in February and March!

Personal data

Salutation: Mr. Ms.

Titel/First name:

Last name:

Address:

Post code^*)/Town:

^*) Please no country sign!

Country:

Telephone:

Email:

Email (Check):

Your car

Model:
other Model:

Type:

Licence plate:^*):

^*) eg "W-24929R".

Capacity/Power/Year^**):

^**)ccm/HP, not KW!/Year of construction please only the year (eg "1966")

Announcement

Please enter the announcement to be read at the race:

Your Club

My Oldtimerclub:
other:

I agree to the electronic storage of my data solely for the purpose of information about the Seiberer-award-of-the-mountain. I would like to receive such information by email.