2014 FIA ERC JUNIOR CHAMPIONSHIP FOR DRIVERS
APPLICATION FORM (1/4)
The FIA ERC Junior Championship is organized by FIA in cooperation with EUROSPORTEVENTSLtd.
Drivers seeking to enter the 2014 FIA ERC Junior Championship for Drivers must complete and sign this application form and return it to EUROSPORTEVENTSLtd.
DETAILS OF THE APPLICANT
Name: ......
Firstname......
Country:......
Address:......
Postcode:......
City:......
Currency:......
SIRET N°: ......
(if French Company)
VAT N°:......
Payment Condition:......
Tel ......
Mobile ......
Fax ......
E-mail ......
2014 FIA ERC JUNIOR CHAMPIONSHIP FOR DRIVERS
APPLICATION FORM (2/4)
PERSONAL DETAILS
Date of birth ......
City & Country of birth ......
Nationality ......
Country of residence ......
Website ......
□ Male □ Female
LICENCE DETAILS
Competition licence number......
Issuing ASN ......
SIZES (for Welcome pack: 2 Shirts, 1 cap, 1 Jacket, 1 patch for racing suit for each, 2 flags for service tent)
Driver □ S □ M □ L □ XL
Co-Driver □ S □ M □ L □ XL
2014 FIA ERC JUNIOR CHAMPIONSHIP FOR DRIVERS
APPLICATION FORM (3/4)
DETAILS OF A PROJECT MANAGER
If correspondence must be sent to a project manager on behalf of the applicant, please provide his/her details below:
Name ......
Tel ......
E-mail ......
ATTACHMENTS AND REQUIREMENTS
□ Driver Profile: The Driver Profile must be completed and enclosed.
□ Application Fee Form:
A fee of € 500 must be paid before an application can be considered.
A deposit of € 1000must be paid before an application can be considered and will be totally refund after 3 rounds participations
□ Limited media license & Accreditation form: must be completed and enclosed.
□ ID card or passport copy must be enclosed
DECLARATION
I confirm that I have read and understood the provisions of the FIA’s International Sporting Code and the 2014 FIA Regional Rally Championship Sporting Regulations.
I agree to be bound by them (as supplemented or amended) and furthermore I agree on my own behalf and on behalf of everyone associated with my participation in the 2014 FIA ERC Junior championship to observe them.
I confirm that I am born on or after 1 January 1989, that I have not competed in a WRCevent with P1 status and that to the best of my knowledge I am eligible and able to compete in the 2014 FIA ERC Junior Championship.
2014 FIA ERC JUNIOR CHAMPIONSHIP FOR DRIVERS
APPLICATION FORM (4/4)
The Applicant acknowledges and agrees that all rights, title and interest in connection with the FIA European Rally Championship, including without limitation all copyrights, database rights, and any and all related rights and neighbouring rights, audio-visual rights, domain name rights, trade name and trade mark rights including “FIA”, “Regional Rally”, “Regional Rally Championship”, “ERC” and “FIA Regional Rally Championship” (and any translation or permutation thereof), together with any associated goodwill vested therein are the exclusive property of the FIA. Any use of such rights by the Applicant other than for the purposes agreed by FIA (or its nominee) in writing is not permitted.
The Applicant also acknowledges and agrees that the FIA and EUROSPORT EVENTS may create and use any recording or replication of the Applicant taking part in events of the FIA European Rally Championship (including the image, logo, livery, colours, name, word mark and likeness of the Applicant’s team, car, uniforms, driver(s) and teammembers, as well as the name and logos of team sponsors present within Applicant’s livery) in any form without any need for consent, license or payment, for any and all purposes that are in the interest of promoting the FIA European Rally Championship. Such use shall be extended to any broadcaster, media partner, championship sponsor or licensee at the FIA’s and EUROSPORTEVENTS’ sole discretion. Such use shall include (but not be limited to) audio-visual recordings, photographs, all forms of editorial coverage, information guides, promotional items, interactive games and any item featuring the Applicant alongside 2 other participants in the FIA European Rally Championship. EUROSPORT EVENTSshall ensure that such use shall always provide a fair, impartial and accurate representation of the Applicant and not imply or suggest the Applicant’s endorsement of a product or service. The FIA (or its nominee) shall make reasonable efforts to adhering to relevant branding guidelines as may be issued by the Competitor.
I declare that I have examined this Registration Form and that the information given is true, correct and complete.
FULL NAME OF APPLICANT......
SIGNATURE ......
DATE ......
DRIVER PROFILE (1/2)
PERSONAL PROFILE
Tell us about yourself
......
......
......
CAREER PROFILE
First rally
......
Major achievements in rally
......
......
......
Major achievements in other motor sports
......
......
......
Major achievements outside motor sports
......
......
......
DRIVER PROFILE (2/2)
ASN PROGRAMME
Are you a part of a national talent program by your ASN: □ Yes □ No
If yes, please provide contact details of the program manager
Name ......
Tel ......
E-mail ......
2013 PROGRAMME Details of your rally program in 2013
Year / Rally Car / Result (Overall & Class)ERC RECORD List all ERC Rallies that you have started (as driver or co-driver)
Year / Rally Car / Result (Overall & Class)PLANS FOR 2014Events that you intend to/hope to contest in addition to the FIA ERC Junior Championship
------
------
------
------
APPLICATION FEE (1/1)
The application fee for the FIA ERC Junior Championship is € 500,00 VAT excl.
In addition, a deposit of € 1000,00 VAT excl. must be paid. This deposit will be fully refunded after 3 rounds participations.
Successful applicants will be offered a place in the 2014 FIA ERC Junior Championship. Others will have this application fee refunded.
Please note that application fees will not be refunded if an applicant withdraws from the FIA ERC Junior Championship after having been offered a place.
PAYMENT PROCEDURE
1)Complete and sign Application form, driver profile and media accreditation
2)Send it to Eurosport Events, to the attention of Jean-Baptiste LEY
3)You receive the invoice for application fee, sent by Eurosport Events
4)Do the payment and send bank confirmation to
Eurosport Events contact details
Eurosport Events
Jean-Baptiste LEY
FIA European Rally Championship Coordination
3, rue Gaston et Rene Caudron
92798 Issy-Les- Mix Cedex 9
France
FOR PAYMENT BY BANK
Payment of the Application Fee must be made to the following bank account and a copy of the proof of payment must be attached to this application.
Bank Details:
Euro Payment
Iban no: GB42BARC203775 56724499
Swiftcode: BARCGB22
2014 ERC
LIMITED MEDIA LICENSE & ACCREDITATION (1/1)
Members of the media employed by or supplying a recognised media platform in relation to distribution of audio-visual rights and/or content are invited to apply for accreditation for limited parts of 2014 FIA European Rally Championship (the "ERC" or the "Series").
- Submission of this form does not guarantee accreditation.
- This accreditation form is restricted to representatives of recognized television channels, official news websites or official motorsport websites. Further, the represented organisation must not be otherwise contracted with Eurosport SAS or its affiliates in relation to distribution of ERC television rights.
- This application form must be signed by the representative(s) applying hereby to attend the relevant Event(s)an authorised signatory of the relevant channel/website.
Your application must be signed and joined to the registration form.
(any queries regarding these applications should be directed to AntoniosArgyropoulos on +33 1 40 93 8517 or )
Applicant Name:...... Mobile Ph:......
Entity you represent:......
Authorised signatory for that entity: ......
VAT/Tax Authority number:......
Phone:...... Fax: ......
Email:......
Postal Address:......
Permitted Usage 1.Team internal purposes (training, analysis, support materials etc)
2. External advertising, public relations and promotional materials, which is directly or indirectly connected to the Team's participation in the ERC
Maximum Agreed Duration:For Internal Purposes: no limit. For external purposes any broadcast or public viewing is prohibited (including without limitation usage on Team/Manufacturer websites)
Applicable Fee: € 0 per Event for which the Applicant is accredited
Accreditation approved by Eurosport SAS (if signed)
......
Name:………………………………………………………
Position: ......
Date:
© Eurosport Events Ltd.
55 Drury Lane
London WC2B 5SQ
United Kingdom
T: +44 207 468 7777
F: + 44 207 468 0024
Registered in England & Wales
under No 436188
VAT No: GB 792 1320 40