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<span class="text"><font color="#000000" class="text"> <form method="POST" action="/mailerCustom.html" target="_top"> <input type="hidden" name="theMessage" value="Thank you for your entry. You will hear back shortly." /><input type="hidden" name="endurl" value="/content.html?page=4" /> <input type="hidden" name="reqs" value="Email Address" /> <table border="0" width="100%" cellspacing="0" cellpadding="10"> <tbody> <tr> <td> </td> </tr> <tr> <td><b><font size="3">2010 Application for Entry:</font></b><br /> <br /> NOTE: All fields marked with an asterisk are optional. ALL OTHER FIELDS ARE REQUIRED. We take the privacy of our entrants very seriously and we NEVER release personal or contact information to anyone for any reason. <table border="0" width="100%" cellspacing="0" cellpadding="10" id="table5"> <tbody> <tr> <td> <table border="1" width="100%" cellspacing="0" cellpadding="10" bgcolor="#FAF7DE" bordercolor="#CCCCCC" id="table6"> <tbody> <tr> <td><b>DRIVER INFORMATION:</b><br /> <table border="0" width="100%" cellspacing="0" cellpadding="4" id="table7"> <tbody> <tr> <td width="154">Name:</td> <td><input type="text" name="Name" size="43" /></td> </tr> <tr> <td width="154">Address 1:</td> <td><input type="text" name="Address_1" size="43" /></td> </tr> <tr> <td width="154">Address 2*:</td> <td><input type="text" name="Address_2" size="43" /></td> </tr> <tr> <td width="154">City:</td> <td><input type="text" name="City" size="43" /></td> </tr> <tr> <td width="154">State:</td> <td><input type="text" name="State" size="16" /></td> </tr> <tr> <td width="154">Postal Code:</td> <td><input type="text" name="Postal_code" size="16" /></td> </tr> <tr> <td width="154">Country:</td> <td><input type="text" name="Country" size="22" /></td> </tr> <tr> <td width="154">Day Telephone:</td> <td><input type="text" name="Day_telephone" size="22" /></td> </tr> <tr> <td width="154">Evening Telephone:</td> <td><input type="text" name="Evening_telephone" size="22" /></td> </tr> <tr> <td width="154">Email Address:</td> <td><input type="text" name="Email Address" size="43" /></td> </tr> <tr> <td width="154">Emergency Contact Name:</td> <td><input type="text" name="Emergency_contact_name" size="43" /></td> </tr> <tr> <td width="154">Emergency Contact Telephone:</td> <td><input type="text" name="Emergency_Contact_telephone" size="22" /></td> </tr> <tr> <td width="154">Brief Personal History <br /> (used for press materials):</td> <td><textarea rows="5" name="Personal_History" cols="28"></textarea></td> </tr> <tr> <td width="154">Shirt Size:</td> <td><select size="1" name="Shirt_size"> <option>Select one...</option> <option value="Small">Small</option> <option value="Medium">Medium </option> <option value="Large">Large</option> <option value="X-Large">X-Large </option> <option value="XXL">XXL</option> </select></td> </tr> <tr> <td width="154">Jacket Size:</td> <td><select size="1" name="Jacket_size"> <option>Select one...</option> <option value="Small">Small</option> <option value="Medium">Medium </option> <option value="Large">Large</option> <option value="X-Large">X-Large </option> <option value="XXL">XXL</option> </select></td> </tr> </tbody> </table> <p><b>CO DRIVER INFORMATION:</b><br /> <br /> If your co-driver is undetermined at time of submission, click here: <input type="checkbox" name="Codriver" value="Codriver" /></p> <table border="0" width="100%" cellspacing="0" cellpadding="4" id="table9"> <tbody> <tr> <td width="154">Name:</td> <td><input type="text" name="codriver_Name" size="43" /></td> </tr> <tr> <td width="154">Address 1:</td> <td><input type="text" name="codriver_Address" size="43" /></td> </tr> <tr> <td width="154">Address 2*:</td> <td><input type="text" name="codriver_Address_2" size="43" /></td> </tr> <tr> <td width="154">City:</td> <td><input type="text" name="codriver_City" size="43" /></td> </tr> <tr> <td width="154">State:</td> <td><input type="text" name="codriver_State" size="16" /></td> </tr> <tr> <td width="154">Postal Code:</td> <td><input type="text" name="codriver_Postal_code" size="16" /></td> </tr> <tr> <td width="154">Country:</td> <td><input type="text" name="codriver_Country" size="22" /></td> </tr> <tr> <td width="154">Day Telephone:</td> <td><input type="text" name="codriver_Day_telephone" size="22" /></td> </tr> <tr> <td width="154">Evening Telephone:</td> <td><input type="text" name="codriver_Evening_telephone" size="22" /></td> </tr> <tr> <td width="154">Email Address:</td> <td><input type="text" name="codriver_Email" size="43" /></td> </tr> <tr> <td width="154">Emergency Contact Name:</td> <td><input type="text" name="codriver_Emergency_contact_name" size="43" /></td> </tr> <tr> <td width="154">Emergency Contact Telephone:</td> <td><input type="text" name="codriver_Emergency_Contact_telephone" size="22" /></td> </tr> <tr> <td width="154">Brief Personal History <br /> (used for press materials):</td> <td><textarea rows="5" name="codriver_Personal_History" cols="28"></textarea></td> </tr> <tr> <td width="154">Shirt Size:</td> <td><select size="1" name="codriver_Shirt_size"> <option>Select one...</option> <option value="Small">Small</option> <option value="Medium">Medium </option> <option value="Large">Large</option> <option value="X-Large">X-Large </option> <option value="XXL">XXL</option> </select></td> </tr> <tr> <td width="154">Jacket Size:</td> <td><select size="1" name="codriver_"> <option>Select one...</option> <option value="Small">Small</option> <option value="Medium">Medium </option> <option value="Large">Large</option> <option value="X-Large">X-Large </option> <option value="XXL">XXL</option> </select></td> </tr> </tbody> </table> <p><b>CLASSIFICATION FOR ENTRY: </b> <br /> <br /> The Carolina Trophy has two classes of competition competitive and touring. Detailed descriptions can be found in the 2010 Information and Rules, but a brief description of the categories is as follows:<br /> <br /> <b>COMPETITIVE: </b>This class is designed for the competitive rallyist, or for the entrant who wants to experience what a competitive rally is like. You will start each stage in one-minute intervals, your timing and scoring will be conducted based on strict class rules, and your route book will be available to you every morning exactly 45 minutes prior to your start time. You may not switch cars without penalty during the event, etc. This class is great fun, but with a structure that is designed to satisfy the competitive rallyist.<br /> <br /> <b>TOURING: </b>The touring class is designed for entrants who do not care as much about their rally score, and are more interested in simply enjoying the drive. The touring class is still timed and scored, but the timing and scoring is more relaxed and streamlined. You can collect your route book whenever you want (in an allowable window of time before the start) you can start whenever you want (within an allowable window of time), you can start alone or in groups with other touring class entrants. It is a far more relaxed, streamlined version of the road rally.<br /> <br /> <select size="1" name="Classification"> <option>Select one...</option> <option value="Competitive">Competitive </option> <option value="Touring">Touring</option> </select></p> <p><b>MEDIA:</b><br /> <br /> Would you consider allowing a member of the media to ride with you on a portion of the event? <br /> <select size="1" name="Media_ride"> <option>Select one...</option> <option value="Yes">Yes</option> <option value="No">No</option> <option value="Contact me to discuss"> Contact me to discuss </option> </select><br /> <br /> Would you be willing to allow the organizers to mount a video camera in or on your car for a portion of the event? <br /> <select size="1" name="Video_camera"> <option>Select one...</option> <option value="Yes">Yes</option> <option value="No">No</option> <option value="Contact me to discuss"> Contact me to discuss </option> </select></p> <p><b>VEHICLE INFORMATION:</b><br /> <br /> Note: A recent photograph of your car will be required before July 1, 2010. Please email a digital file to: <a href="mailto:info@carolinatrophy.com"> info@carolinatrophy.com</a> or mail a hard copy to The Carolina Trophy PO Box 1181, Vienna, VA 22180 USA. Hard copies cannot be returned. A photo is not necessary if you are a returning entrant and are competing in the same car in which you previously contested the Carolina Trophy.</p> <table border="0" width="97%" cellspacing="0" cellpadding="4" id="table8"> <tbody> <tr> <td width="154">Owner of Car:</td> <td><input type="text" name="Owner_of_car" size="43" /></td> </tr> <tr> <td width="154">Year:</td> <td><input type="text" name="Year" size="22" /></td> </tr> <tr> <td width="154">Make:</td> <td><input type="text" name="Make" size="22" /></td> </tr> <tr> <td width="154">Model:</td> <td><input type="text" name="Model" size="22" /></td> </tr> <tr> <td width="154">Chassis/Vin #:</td> <td><input type="text" name="Chassis_Vin" size="43" /></td> </tr> <tr> <td width="154">Exterior color:</td> <td><input type="text" name="Exterior_color" size="22" /></td> </tr> <tr> <td width="154">Body Style:</td> <td><select size="1" name="Body_style"> <option>Select one...</option> <option value="Two-Door Sedan"> Two-Door Sedan </option> <option value="Four-Door Sedan"> Four-Door Sedan </option> <option value="Fixed Head Coupe"> Fixed Head Coupe </option> <option value="Convertible"> Convertible </option> <option value="Shooting Brake"> Shooting Brake </option> <option value="Other">Other</option> </select></td> </tr> <tr> <td width="154">Country of manufacture:</td> <td><input type="text" name="country_manufacture" size="43" /></td> </tr> <tr> <td width="154">Engine type:</td> <td><input type="text" name="engine_type" size="43" /></td> </tr> <tr> <td width="154">Displacement:</td> <td><input type="text" name="displacement" size="43" /></td> </tr> <tr> <td width="154">Horsepower:</td> <td><input type="text" name="horsepower" size="43" /></td> </tr> <tr> <td width="154">Gearbox type:</td> <td><input type="text" name="gearbox_type" size="43" /></td> </tr> <tr> <td width="154">Vehicle history <br /> (used for press materials):</td> <td><textarea rows="5" name="vehicle_history" cols="28"></textarea></td> </tr> </tbody> </table> <p><b>PUBLICITY RELEASE:</b><br /> <br /> As a condition of entry into the Carolina Trophy, the vehicle owner, driver and co-driver(s) hereby agree to permit The Carolina Trophy, its organizers and partners, to use our names, likenesses and/or voices for news and publicity in any or all media or event advertising. We agree that this agreement is in conflict with no prior agreement.</p> <p>I agree to the terms: <input type="checkbox" name="agree_to_terms" value="agreed_to_terms" /></p> <p><b>PAYMENT INFORMATION:</b><br /> <br /> The entry fee for a car and two entrants, double occupancy, is USD$4,950.00. Additional rooms are available in the hotel at USD$1,550.00 each if desired. A deposit of USD$1,000.00 can be submitted to enter the event, with the balance due no later than July 1, 2010. We accept payment by check (made out to "Rally Sportif, LLC") and major credit cards. Credit card charges should be processed through PayPal by using the "payments" link on this web site. After clicking the submit button below, a representative of the Carolina Trophy will contact you directly to discuss your application and payment arrangements.</p> <p><b>REFUNDS AND WITHDRAWALS:</b><br /> <br /> If your application to the event is refused, your deposit is fully refundable. If your application is accepted, the deposit is 100% refundable through June 30, 2010. After June 30, 2010 no refunds or credits can be guaranteed under any circumstances.</p> <hr color="#CCCCCC" /> <p align="center"><input type="submit" value="Submit" name="submit" /></p> </td> </tr> </tbody> </table> </td> </tr> </tbody> </table> <p><br /> </p> </td> </tr> </tbody> </table> <p> <img width="1" height="27" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="19" border="0" alt="" src="images/spacer.gif" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p><img width="1" height="19" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="18" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="18" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="18" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="19" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="18" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="19" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="25" border="0" alt="" src="images/spacer.gif" /> <img width="1" height="295" border="0" alt="" src="images/spacer.gif" /></p> </form> </font></span><br> <h1> Entry application for the 2010 Carolina Trophy road rally, the five-day, 1000km road rally through the Blue Ridge and Great Smoky mountains.</h1>
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PO Box 1181 Vienna, VA 22180 (704) 351 2087
