Registration

XI VEL. TIERRA
LA PICONERA
10 October, 2026

REGISTRATION FORM
Registration finish: September 30, 2026 at 14:00

It can automatically fill out the form from an inscription recorded previously , in this or any other rally, for it must indicate the key registration to import and click the Import Registration button

RED fields are required.

PERSONAL DATA

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Team or name and surname if individual competitor:

Team:

Address:

City:

Postal Code:

State:

Country:

License:

Copy:

Mobile Phone:

Phone 2:

Fax:

Passport / CTC:

Email:

D
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V
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Name:

Surnames:

Passport

Address:

City:

Postal Code:

State:

Country:

Birthdate:

License:

Cell phone:

Email:

C
O
D
R
I
V
E
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Name:

Surnames:

Passport

Address:

City:

Postal Code:

State:

Birthdate:

License:

Cell phone:

Email:

VEHICLE INFORMATION

Make:

Model:

Displacement:

Turbo:
NO
SI

Traction:

License plate:

No. approval Sheet:

Chassis Number:

The competitor declares under its responsibility that
the vehicle must be registered as follows:

REGIONAL

Group:

Class/Category:

CATEGORY / TROPHIES AND CUPS IN WHICH IT PARTICIPATES

SUPERCOPA AT DE FUERTEVENTURA

REGISTRATION FEES (This registration will not be valid without the corresponding bank deposit)

WAY TO PAY
By transfer or deposit account
ES67 2100 3530 1613 0036 7726, CaixaBank
(The costs will be on the payer)
Send Receipt to: Email: stiftv@hotmail.com

WITH OPTIONAL ADVERTISING
GENERAL: 160€
PART. AÑO ANTERIOR - CUF - SUPERCOPA AT: 130€

WITHOUT OPTIONAL ADVERTISING
GENERAL: 320€
PART. AÑO ANTERIOR - CUF - SUPERCOPA AT: 260€

SHARE ASSISTANCE

Names:

SPORTS AWARDS

Event name (1):

Year (1):

Final standings (1):

Event name (2):

Year (2):

Final standings (2):

Event name (3):

Year (3):

Final standings (3):

INVOICE

Billing information:

ATTACH DOCUMENTATION

ATTACH DOCUMENTATION IS ONLY AVAILABLE IN EDITING MODE

¡ ATENCIÓN ! Es responsabilidad de los participantes consultar y/o descargar toda la documentación oficial de la prueba desde la página web

Participants responsible for the information contained in this document and declare to know the rules by which the Test, which are obliged to respect are governed are made.

BASIC INFORMATION ON DATA PROTECTION
Responsable	Víctor Manuel Robayna Mosegue (VMRM System)
Purpose	Registration and data processing in sports event
Legitimation	Consent of the interest party
Recipients	Sports Event Organizer
Rights	You have the right to access, rectify and delete the data in vmrm@vmrm.net as well as the right to file a claim with a control authority
Additional Information	You can consult the additional and detailed information on Data Protection at http://www.vmrm.net referring to our Legal Notice and Privacy Policy

I have read and accept the Legal Notice and the Privacy Policy.

I authorize the transfer of my data to the Club Deportivo Tibiabín to formalize the registration in the sports event organized by this entity..

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