2000 Alcan Winter Rally

Official Entry Form
 
DRIVER 

Name _______________________________________  

Address______________________________________ 

City/State/Zip_________________________________ 

Phone (___)_____________ Fax (___)_____________ 

E-mail ______________________________________ 

Driver license # & state________________________ 

Emergency contact ____________________________
SECOND DRIVER

Name _______________________________________  

Address______________________________________ 

City/State/Zip_________________________________ 

Phone (___)_____________ Fax (___)_____________ 

E-mail ______________________________________ 

Driver license # & state________________________ 

Emergency contact ____________________________
VEHICLE 

Year_____________ Make______________________ 

Model _______________________________________ 

License #____________________ State___________ 

Color___________________ 

Owner ______________________________________ 

Insurance Company __________________________ 

Policy # _____________________________________
THIRD DRIVER

Name _______________________________________  

Address______________________________________ 

City/State/Zip_________________________________ 

Phone (___)_____________ Fax (___)_____________ 

E-mail ______________________________________ 

Driver license # & state________________________ 

Emergency contact ____________________________
Previous experience: 

Fee and reservation information
  • Entry Fee ($2500): The entry fee for one vehicle and 2 drivers, including all accommodations and banquets.
  • Third Driver ($500): Additional fee for a 3rd driver or team member.
  • Entry deposit ($250): This will reserve a starting position, and apply in full against total entry fees above.  This deposit is refundable through December 4, 1999.
  • Starting position:  Car numbers will be assigned in the approximate order that entries are received, with a few numbers reserved for past Alcan winners and factory teams.
  • Advertising waiver ($500): Fee for the waiver of the event's advertising display requirements (see regulations for details).
  • Refund policy: Entry fees are fully refundable through January 15, 2000. After that date refunds will be 50% in cash and 50% in the form of a credit towards a future Alcan event.
  • Visa, Discovery, and Mastercard are accepted. All fees will be paid in full by January 4, 2000.

    • The limit will be 30 teams, with 10 positions for first-time entrants. Mail, e-mail, or fax to: 

    Jerry Hines                     |       jhines@eskimo.com
Alcan Rally Chairman            |       (425)823-6343
13 Central Way #300             |       (425)823-6307 fax 
Kirkland, WA 98033              |       http://www.alcan5000.com/
    Credit Card Information
    Cardholder's name ____________________________________________________________
    Card Number __________________________________________________________________
    Dollar amount of charge _________________________ Epiration Date _____________
    Signature of Cardholder ______________________________________________________ 
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