2020 Alcan Winter Rally entry form

Alcan Winter Rally entry
February 27 to March 7, 2020

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 ___________________________

Related experience:

Past entrant, year(s):

Fees & information

Entry Fee ($3200): Fee for one auto and 2 drivers. Includes double occupancy accommodations for 9 nights plus some hosted meals.
Entry reservation ($300): Reserves a starting position and will apply in full against total. Not refundable after August 1, 2019.
Starting position: Vehicles will start in numerical order. Numbers will be assigned in approximate order entries were received, with adjustments for past winners and entrants.
Refund policy: Entry fees (except reservation) are fully refundable through January 20, 2020. After this a $600 room cancellation penalty will be retained.
Third driver ($800): Additional fee for a 3rd driver or team member (double occupancy).

Credit cards, checks and Square are accepted. Make checks payable to Alcan Rally or Rainier Auto Sports Club, Inc. Full payment is due by December 15, 2019.

Mail, e-mail, or fax to:

Alcan Rally                 |       425-823-6343 voip

932 Sunnyfield Way    |       425-609-0084 fax

Henderson, NV 89015 |      alcan5000@gmail.com

Credit Card Info (Or just check here for a Square email invoice_____)

Cardholder name ____________________________________________________________

Card Number _______________________________________________________________

Dollar amount of charge ________________ Expiration ____________ CSC/CVC#_______

Signature of Cardholder ______________________________________________________

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