Alcan Entry Form printable pdf download

2018 Alcan 5000 entry form

2018 Alcan entry

August 20 - 28, 2018

DRIVER or RIDER

SECOND DRIVER

Name ______________________________________

Address____________________________________

City/State/Zip________________________________

Phone (___)_____________ Fax (___)____________

Phone (___)_____________ Fax (___)___________

E-mail ______________________________________

E-mail _____________________________________

Driver license # & state________________________

Driver license # & state_______________________

Emergency contact ___________________________

VEHICLE

THIRD DRIVER

Year_____________ Make______________________

Name _______________________________________

Model ______________________________________

Address_____________________________________

License #____________________ State___________

City/State/Zip_________________________________

Color___________________

Phone (___)_____________ Fax (___)____________

Owner ______________________________________

E-mail ______________________________________

Insurance Company __________________________

Driver license # & state________________________

Policy # _____________________________________

Emergency contact ___________________________

Related experience:

Fees and information

Entry Fee, autos ($3000): Fee for one auto and 2 drivers, including accommodations (double occupancy) and banquets.

Entry Fee, cycles ($2000): Fee for one motorcycle & rider, including accommodations (double occupancy) and banquets.

Entry deposit ($200): This will reserve a starting position, and apply in full against entry fee. Deposit is non-refundable after

January 1, 2018, and may not be resold.

Starting position: Vehicles will start in numerical order. Numbers will be assigned within group (auto or cycle) in the

approximate order received, with priority for past Alcan winners and participants.

Refund policy: Entry fees except $200 deposit are fully refundable through June 18, 2018. After this a $500 lodging penalty

will be retained.

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Alcan Entry Form