4X4 X-Treme

ORGANISER: HIMALAYAN MOTORSPORT ASSOCIATION
Date of Event - October 6 - 14, 2018

Driver Details
Full Name* :   Father's Name* :
Address* :   Phone* :
Blood Group* :   E-Mail* :
Date of Birth* :   Password* :
Comp Lic # :   Driving Licence* :
Personal Accident Insurance Details
PA Policy No. :   Amount :
Issued By :   Validity :
Co-Driver Details
Full Name* :   Father's Name* :
Address* :   Phone* :
Blood Group*     E-Mail* :
Date of Birth* :   Driving Licence* :
Comp Lic # :        
Personal Accident Insurance Details
PA Policy No. :   Amount :
Issued By :   Validity :
Entrant
Full Name :   Father's Name :
Address :   Ent. Licence No. :
Details of Car/SUV
Make Model Registn. No Chassis No Engine No.
         
Group Class Cubic Capacity(cc)
List of documents required
Photocopy of driver's license for all drivers
Driver
Co-Driver
Entrant
Photocopy of FMSCI Competition license for all occupants
Driver
Co-Driver
Entrant
Photocopy of blood group report for all occupants with name and blood group specified at the back
Driver
Co-Driver
Photocopy of personal accident insurance (heavy risk) for min 5 lakh each for all occupants
Driver
Co-Driver
One passport size pics of all occupants
Driver
    
Co-Driver
    
Photocopy of vehicle's insurance

Photocopy of vehicle's rally insurance

Photocopy of vehicle's registration

Authority letter from owner incase car is not owned by competitor
This letter has to be on a Rs.100/- stamp paper attested by a magistrate.

Separate signed copy of indemnity form on Rs.50/- stamp paper per crew member attested by notary.
Driver
Co-Driver
Entrant