REGISTRATION 2025

PARTICIPANT DETAILS

NAME *

First

Last

DOB *

NATIONALITY

ADDRESS / ZIP / COUNTRY *

EMAIL *

MOBILE PHONE NUMBER *

BLOOD TYPE *

FMN / LICENSE NO. / FEDERATION

PERSONAL INSURANCE CONTRACT NO.

TEAM / SPONSOR

PASSPORT NO. *

DRIVING LICENSE NO. *

T-SHIRT SIZE *

HOODIE SIZE (+40 Euros)

ONLY SSV Class

CO-DRIVER'S NAME

First

Last

CO-DRIVER'S BLOOD TYPE

CO-DRIVER'S NATIONALITY

CO-DRIVER'S EMAIL

CO-DRIVER'S MOBILE NO.

CO-DRIVER'S PASSPORT NO.

CO-DRIVER'S LICENSE NO.

CO-DRIVER'S PERSONAL INSURANCE CONTRACT NO.

CO-DRIVER'S FMN / LICENSE NO. / FEDERATION

CO-DRIVER'S T-SHIRT SIZE

CO-DRIVER'S HOODIE SIZE (+40 Euros)

VEHICLE DETAILS

VEHICLE OWNER

MOTORBIKE / SSV - MAKE / MODEL / CC *

INSURANCE COMPANY NAME *

INSURANCE EXPIRE DATE *

REGISTRATION PLATE NO.

ENGINE NUMBER

CHASSIS NUMBER

CATEGORY *

CLASS [ IF EXISTS ]

ROADBOOK *

TERRAPIRATA EMAIL

Enter the email you have registered with Terrapirata. This email will be put into the system so you can have access to the road book via Terrapirata.

SERVICE AND SUPPORT

ASSISTANCE CAR TYPE *

DIMENSIONS AUTO / TRUCK / VAN [m x m]

PADDOCK TENT DIMENSIONS [m x m]

NUMBER OF PEOPLE *

NAME(s) & SURNAMES(s)

Write down all the names of your family or crew that will be present for the rally.

EMERGENCY CONTACTS

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT NUMBER *

RELATIONSHIP

FILE UPLOAD

Drag & Drop Files, Choose Files to Upload You can upload up to 8 files.

Upload your Passport, driving License, racing license + Starting permission or Personal Insurance for motosports with repatriation, Vehicle documents and Bike Insurance. File types allowed are PDF, JPG, JPEG, PNG, with a maximum file size of 5MB

ADDITIONAL NOTES

CONSENT *

I accept the above terms and conditions.

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