Registration 2016 TeamCo-driver DriverTeam name*First name*Co-driver first name*Last name*Co-driver last name*Date of Birth*Co-driver date of Birth*Nationality*Co-driver nationality*Sex*Co-driver sex*Postal address* Co-driver postal address mobile-show* Email* Co-driver email* Phone*Co-driver phone*Car detailsCar brand*Year made*Predominant color*Country of registration*Battery capacity, maximum range*The charging plug standard*Type of car*All electricPlug in hybridOtherENTRY FEESType of participation*Full Marathon - 2800 €Single Stage - to join Electric Marathon on a single stage, please contact firstname.lastname@example.orgEntry fee includes: - Free accommodation from 21st May until 4th June. (Twin room with breakfast for each team will be provided) - Invitation to the Official Dinner in Lviv before the start of the Event - Administrative costs - Free charging at locations offered by Organizer - Official T-shirt and baseball cap of the Event - Road book - GPS tracking system - Entry tickets to the Museums - 24/7 Support during the Event Entry fee does not include - All the other costs that are not included in the Entry Fees must be paid by the participants.Declaration of indemnityI accept without reserve the terms of the Electric Marathon 2015 I understand that I should take out any insurance that I consider appropriate covering my own personal injuries and property damage. I hereby agree to indemnify and hold harmless the organizers, its representatives and staff for any liability in respect of personal injury, property and other damage suffered by me, arising out of the competition and which would not be covered by the insurance taken out by the organizers for the Electric Marathon 2015. Organizer retains the right to decline a participant in registration without an explanation and disqualify participant for rules violation. Acknowledgement and agreementAgreement* Agree to declare that all the information contained on my entry form is correct and that I fully understand and agree to the terms and conditions of the above indemnity and that I accept all the terms and conditions relating to my participation in this event. Attention! The organizers reserve the right to change the route in case of strikes, repair of roads, lack of opportunity to charge the car at the place of destination.Captcha PhoneThis field is for validation purposes and should be left unchanged.