35th year of the
ŠKODA Economy Run
Kosmonosy – Vrchlabí – Kosmonosy
24th of September 2016

Driver	T-shirt size
Last name :		First name :			 S    M    L   XL  XXL
Navigator	T-shirt size
Last name :		First name :			 S    M    L   XL  XXL
Vehicle
Please, note, that you must attach a copy of the certificate of roadworthiness (technical specification of competing car and its standard consumption) to the filled application form.
Please notice the Paragraph 3 of Propositions with the restriction for competing car !!
We are representing
Town :		
Journal / Dealer/ Škoda department :		
Contact :
Name :			Street, no. :		
Town : 			ZIP :		
E-mail :			Phone :		
GSM :			Fax :			
By sending this application we agree to be bound by the Regulations and we are fully acquainted with.