gp portugal - guimarães 6 . 7 mai maxxis fim enduro world

G.P. PORTUGAL - GUIMARÃES 6 . 7 MAI
MAXXIS FIM ENDURO WORLD CHAMPIONSHIP
2006 ENTRY FORM
IMN
FMNR
VENUE
DATE
CLUB
TEL/FAX
402/01
SVEMO Östersund
402/02
FNM
Guimarães
402/03
RFME
Gemika
18/19.03.06 Fältjärgarna
enduroförening
enduroförening
06/07.05.06 Motor Clube de
Guimarães
13/14.05.06 Gemika Off-Road
402/04
FMI
Rovelta
17/18.06.06 Moto Club Bergamo
402/05
CMA
402/06
AMA
402/07
SMF
402/08
FFM
Parry Sound 15/16.07.06 World Enduro
Canada
Hancock NY 22/23.07.06 Bear Creek
Sportmen Club
Krompachy 02/03.09.06 Moto Club Enduro
Kosice
Boussac
23/24.09.06 Moto Club
Boussaquin
+46 635 589 71
+46 635 589 82
+35 125 341 8661
+35 125 341 3322
+34 646 796 042
+34 946 256 840
+39 035 244 757
+39 035 244 757
+51 992 554 15
+90 545 196 04
+90 864 763 85
+90 864 768 40
+42 190 548 4450
+42 155 727 9150
+33 555 657 104
+33 555 657 104
E-MAIL
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
[email protected]
mc.enduro€post.sk
[email protected]
RIDER
SURNAME:
First name:
Date of birth:
Address:
Number:
Postal code:
City:
Country:
Nationality (Passport):
Tel.:
Fax:
E-mail:
FIM Inter. Licence Nº
FIM World Ch. Licence Nº:
Driving Licence Nº:
Team:
Category:
FMN:
MOTORBIKE
Class:
Enduro 1
From 100cc to 125cc 2-str and from 175cc to 250cc 4-str
Enduro 2
From 175cc to 250cc 2-str and from 290cc to 450cc 4-str
Enduro 3
From 290cc to 500cc 2-str and from 475cc to 650cc 4-str
Junior
Open
Make:
Capacity:
Registration Nº:
Insurance Company:
Expiry date:
N.B.:
Type:
2-stroke
4-stroke
Frame Nº:
Policy Nº:
ATTENTION !: Insurance compulsory
The entry forms must be sent to the FMNR/CLUB, together with the entry fee of CHF 250.- (€ 170.-), 30 days
before the first day of the event.