Fuel Economy Drive Entry Form

Entries open immediately and must be on the official form below received on or before 5pm on 2nd September 2016, completed with entry fee of €30.00. All entry fees received will be donated to “Aware”. Entrants will receive a €20.00 Maxol fuel voucher and a complimentary lunch on the day.

Driver/Entrant(*)

Please provide the driver name

Company

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Mobile/Phone(*)

Please provide the mobile/phone number

Email(*)

Please provide your email address

Twitter

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(for the “Treasure Hunt” Award entrants only)

Car Make(*)

Please provide the car make

Model(*)

Please provide the Car Model

Engine CC(*)

Please provide the Engine CC.

Registration(*)

Please provide the car registration

(*)

Petrol

Diesel

Hybrid

Please choose the fuel type

Class Entered(*)

Please provide the class entered

I have read and understood the rules and regulations for this event. I understand that the route is on public roads and I am required to have a road legal vehicle with Tax, Insurance & NCT (if applicable). I fully understand that the rules of the road apply at all times and that there are risks associated with driving on the roads and the organisers have no control over these. Should anything untoward happen I fully indemnify Maxol against any claims arising from any such incident involving me and/or my car and/or its occupants. Invalid Input

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