Classic spring roads Lux Development & Technology (LTD)
Avenue Roger Dejardin, 160 B
4800 Verviers
Belgium
+32 87 27 06 27 / Mob +32 475 30 64 12
willy.lux@classicspringroads.be
 
 ENTRY FORM
What is your language?
  DRIVER CO-DRIVER
Surname-First name :
Address :
Date of birth :
Nationality :
E-mail* :
Mobile :
Driving license :
Regularity License* :
Nr Rally Pass FBVA/BFOV* :
Size :
Choice of category :
Class :  
     
 CAR
Make-Modele-Type :
Year :
Engine capacity :
Registration number :
FIVA/FIA Passport nr :
FBVA Passport nr :
Photograph :
 
INSURANCE
Company :
Contract n° :
Valid until :
 
I need an invoice

 ENTRY FEE

Package 1 with hotel : 995 €

>hotel on Saturday night in a double room
>Saturday lunch buffet
>Saturday dinner
>Sunday lunch
>drinks included
>sports rights, etc...
>Package 2 without hotel : 905 €

>hotel on Saturday night in a double room
>Saturday lunch buffet
>Saturday dinner
>Sunday lunch
>drinks included
>sports rights, etc...
>Package 3 : 815 €

>hotel on Saturday night in a double room
>Saturday lunch buffet
>Saturday dinner
>Sunday lunch
>drinks included
>sports rights, etc...

choose your pack :

extra rooms :
  Friday :
rooms double x 126 €
rooms twin x 126 €
rooms single x 106 €
Saturday :
rooms double x 126 €
rooms twin x 126 €
rooms single x 106 €

additional meals :
  Saturday lunch buffet :
more people x 40 € (drinks included)

Saturday dinner :
more people x 55 € (drinks included)

Sunday lunch :
more people x 45 € (drinks included)
 
your total commitment 

You will find all the information about the payment and registration confirmation in the email that will be sent. In case of problems, do not hesitate to contact us.
If you are having difficulty sending or filling the form, you can print and send by mail.


   
   
   
   
 

 

 

 

 

 

 

 

 

acoutil

 

 

 
   
  paisse
   
   
   
  province de liège