20 UAE ProCar REGISTRATION FORM - dubaiautodrome.ae
Transcript of 20 UAE ProCar REGISTRATION FORM - dubaiautodrome.ae
2021- 2022 UAE ProCar Championship REGISTRATION FORM
UAE ProCar Championship Registration Form 2021/2022 Page 1 of 2
Season Registration Form
I hereby apply for registration for the UAE ProCar Championship 2021/22.
Driver Name: _______________________ Nationality: _______________________
Mobile No.: _______________________ E-Mail Address: _______________________
Race License No.: _______________________ Issued By: _______________________
Address: ______________________________________________________________________
City/Country: _______________________ P.O. Box: _______________________
Name of Entrant: ______________________________________________________________________ (if different)
Mobile No.: _______________________ E-Mail Address: _______________________
Entrant License No.: _______________________ Issued By: _______________________
Address: ______________________________________________________________________
City/Country: _______________________ P.O. Box: _______________________
Please specify contact for all correspondence Driver Entrant
Previous racing experience of driver:
PLEASE ATTACH RACING HISTORY CV GIVING AS MUCH INFORMATION AS POSSIBLE.
Car Details
Make: _______________________ Model: _______________________
Year: _______________________ cc: _______________________
Turbocharged or Supercharged: _____________
Declared Weight of car (Tech. Regs. Art 17): _____________
Stated power level (bhp at the wheels) _____________ (please provide certificate)
2021- 2022 UAE ProCarChampionship REGISTRATION FORM
UAE ProCar Championship Registration Form 2021/2022 Page 2 of 2
Roll Cage Make: _______________________
Fuel Cell Make: _______________________
If exception under Tech. Regs. Art. 5.1. k), date applied for:
EMSO Car Passport: _______________________
Transponder Model: _______________________
Declared Rev. Limit: _______________________
Date of Dyno Test: _______________________
Dyno sheet attached:
Class entered
Class 1: 2wd exceeding 2000cc
Class 3: Homologated GT3 cars
Class 5: Cup and Challenge cars
Class 6: GT or mass production-based cars that do not comply with Classes 1 - 5
Certificated By: _______________________
FIA Number: _______________________
_____________
Transponder No.: _______________________
Class 2: 2wd between 1600 – 2000cc
Class 4: Homologated GT4 cars
Proto Class:
Clio Cup Class
AE86 Class:
Preferred Car Number
N.B. Numbers issued on a first come/first served basis at the final discretion of the Organizers.
Season Registration Options
Season Registration only (AED 2,100 incl. VAT, to be paid before start of the season
Early Bird Full Season (AED 15,540 incl. VAT, valid until 1 October 2021)
I hereby certify that all the information given above is accurate and true. (The Series regulations, Judicial Arrangements and Commercial Undertakings are to be followed)
Name: _______________________ Signature: _______________________ Date: ____________
To submit your entry, please send the completed form to: DAMC, Dubai Autodrome, P.O. Box 57331, Dubai, UAE or email to: [email protected]
[including all Renault Clio Cup Gen 3]
[For all Renault Clio Cup Gen 5]