Entry form Service CrewGogoulos Anastasios2023-11-06T15:11:59+00:00 Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1Entry fees – Team info2Vehicle3Service Person4ImportantLayout Entry form 2024 Service Crew Carta Rallye 2024 | Morocco | 03.03 -09.03.2024 Checkbox ItemsSERVICE PER PERSON – 1.000,00 €SERVICE PER PERSON INC ACCOMMODATION** – 1.250,00 €VEHICLE < 3.5 TONS with trailer * – 400,00 €VEHICLE > 3.5 TONS – 550,00 €* For towing vehicles or trucks <3,5 T (free for non towing 4×4 <3,5T) LayoutTHE FEE INCLUDES: • The breakfasts from the day of the departure of the race to the morning after the price giving ceremony • Dinners during the 7 days of the race and the night before the start THE FEE DON’T INCLUDE: • Medical repatriation insurance (recommended) • Meals and accommodation before the day of departure of the race • Fuel • Lunches • Drinks ** Accommodation during the race (3 nights hotel in shared rooms, 3 nights in own tent, 2 nights in berber tent Team InfoLayoutTEAM NAMENAME TEAM RESPONSIBLENext – VehicleSERVICE VEHICLEVEHICLE < 3.5 TONS *VEHICLE > 3.5 TONS ** For towing 4×4’s and truck <3,5 T (free for non towing 4x4 <3,5T )LayoutREGISTER COUNTRYMANUFACTURERVEHICLE COLOURDATE FIRST REGISTRATIONLICENSE PLATEMODELMultiple ChoicePetrolDieselWhen submitting your entry, we need copies of the following documents: For every vehicle: • Vehicle documents • Possible powers of attorney for the vehicle • Certificate of insurance valid for Morocco • We highly recommend to get a vehicle recovery insurance. Please pay attention to a good readability and that the data volume is as small as possible. File Upload Click or drag files to this area to upload. You can upload up to 10 files. Previous – Entry fees – Team infoNext – Service PersonService crew memberPERSONSURNAMEDATE OF BIRTHSexMaleFemaleFIRST NAMEPLACE & COUNTRY OF BIRTHT-SHIRT SIZESMLXLXXLContactAddressAddress Line 1CityState / Province / RegionPostal Code–Select Country–AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhonesMOBILE PHONE (COMPULSARY)Email *EmailConfirm EmailHOME TELEPHONEFACEBOOK ETCPassportPassportNATIONALITYDATE ISSUEDISSUED BYPASSPORT NOVALID TOMAROC IDMedicalMedical detailsBLOOD TYPEALLERGIESMEDICATION TAKENEmergency ContactEMERGENCY CONTACTSURNAMERELATIONSHIP (WIFE, PARENT)FIRST NAMEEMERGENCY PHONE NO.You need another Service Crew member?YesService crew member 2PERSON 2SURNAME 2nd Crew MemberDATE OF BIRTH 2nd Crew MemberSex 2nd Crew MemberMaleFemaleFIRST NAME 2nd Crew MemberPLACE & COUNTRY OF BIRTH 2nd Crew MemberT-SHIRT SIZE 2nd Crew MemberSMLXLXXLContact 2nd Member CrewAddressAddress Line 1CityState / Province / RegionPostal Code–Select Country–AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhones 2nd Member CrewMOBILE PHONE (COMPULSARY) 2nd Member CrewEmail 2nd Member Crew *EmailConfirm EmailHOME TELEPHONE 2nd Member CrewFACEBOOK ETC 2nd Member CrewPassport 2nd Crew MemberPassport 2nd Member CrewNATIONALITY 2nd Member CrewDATE ISSUED 2nd Member CrewISSUED BY 2nd Member CrewPASSPORT NO 2nd Member CrewVALID TO 2nd Member CrewMAROC ID 2nd Member CrewMedical 2nd Member CrewMedical 2nd Member CrewBLOOD TYPE 2nd Member CrewALLERGIES 2nd Member CrewMEDICATION TAKEN 2nd Member CrewEmergency Contact 2nd Service CrewEmergency Contact 2nd Service CrewSURNAME 2nd Service CrewRELATIONSHIP (WIFE, PARENT) 2nd Service CrewFIRST NAME 2nd Service CrewPhone 2nd Service CrewYou need a 3rd Service crew member?Yes3rd Service crew memberPERSON 3SURNAME 3rd Crew MemberDATE OF BIRTH 3rd Crew MemberSex 3rd Crew MemberMaleFemaleFIRST NAME 3rd Crew MemberPLACE & COUNTRY OF BIRTH 3rd Crew MemberT-SHIRT SIZE 3rd Crew MemberSMLXLXXLContact 3rd Member CrewAddressAddress Line 1CityState / Province / RegionPostal Code–Select Country–AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPhones 3rd Member CrewMOBILE PHONE (COMPULSARY) 3rd Member CrewEmail 3rd Member Crew *EmailConfirm EmailHOME TELEPHONE 3rd Member CrewFACEBOOK ETC 3rd Member CrewPassport 3rd Member crewPassport 3rd Member CrewNATIONALITY 3rd Member CrewDATE ISSUED 3rd Member CrewISSUED BY 3rd Member CrewPASSPORT NO 3rd Member CrewVALID TO 3rd Member CrewMAROC ID 3rd Member CrewMedicalMedical 3rd Member CrewBLOOD TYPE 3rd Crew memberALLERGIES 3rd Crew memberMEDICATION TAKEN 3rd Crew MemberEmergency Contact 3rd Service CrewEmergency Contact 3rd Service CrewSURNAME 3rd Crew MemberRELATIONSHIP (WIFE, PARENT) 3rd Crew MemberFIRST NAME 3rd Crew MemberPhone 3rd Crew MemberPrevious – Crew membersNextWith the deposit payment please upload legible copies of the following documents. Please upload documents as PDF’s. Please pay attention to a good readability and that the data volume is as small as possible. For each car: • Registration document • Car insurance covering Morocco We highly recommend to get a vehicle recovery insurance. For each person: • Passport (valid at least 3 months from date of rally start) • Driving licence •Medivac medical insurance ( recommended) PAYMENT TERMS: The payment of a € 1000 deposit per team validates the registration of a team in a category. The start number is given only when the full amount of the fees has been received, and attributed according to the date of receipt of the full payment. The balance must be paid within 30 days of the initial deposit. Scale of deductions in case of cancellation: • 500 € per team if cancelled before 01/12/2023 • 50% of the total fees if cancelled between 01/12/2023 and 01/02/2024 • 100% of the total fees if cancelled after 01/02/2024 CONTACT: Chris Armelin +44 7966 207715 or ca@rallye-carta.com BANK ACCOUNT Carta Rallye Ltd. Barclays Bank IBAN: GB21BARC20905658909811 SWIFTBIC: BARCGB22 Terms and ConditionsAcceptBy signing this form, you confirm that you accept and comply with the terms of your registration to the event and the valid regulations of the event.NameFirstLastSignatureClear SignaturePrevious – VehicleSubmit
