First Name *

Last Name *

Email *

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Home Phone *

Mobile *

First Name

Last Name

VW-Porsche 914 Model Choose your 914 model... 914/4 - 1.7 914/4 - 1.8 914/4 - 2.0 914/6 916 914GT other *

Model Year Choose Year... 1969 1970 1971 1972 1973 1974 1975 1976 *

Colour *

Registration / Licence Plate *

Is your 914 standard or modified? Select option Standard 914 model Modified 914 *

Interesting features or history about your 914

Book Event Package Select package duration... 2 Night Package - €320 /person 3 Night Package - €380 /person *

Covered parking is now FULL - you must select No Choose parking option... No - outside parking *

Number of people in your 914 How many people in your 914... 1 person 2 persons 3 persons *

Do you have special dietary requirements or food allegies? Select option... Yes No *

If yes state

Please read the booking conditions below relating to the 914 International meeting in 2012. You must accept them to register for the event.

• This is a firm booking for the 914 International event in 2012.
• Participation is limited to VW-Porsche 914 cars
• Registration is only valid after receipt of the registration fee.
• By registering you agree to pay a 100€ deposit within 7 days of registration
• The event fee is not refundable
• I agree to pay the full balance in due course. The closing date for full payment will be announced by the organisers on or before January 10, 2012. I understand that failure to do so may result in my booking being cancelled."
• It is the responsibility of all participants to ensure that their vehicle is
• compliant with all the laws and regulations of the country of registration
• roadworthy for use in Belgium and that all traffic laws will be obeyed
• We recommend that suitable insurance and roadside recovery insurance be taken out by all participants
• Porsche Classic Club Begium reserves the right to adjust or alter the programme due to unforeseen circumstances, as well as practical or safety considerations, without any claims from participants
• Rooms in the hotel(s) are allocated on base of the date of registration and receipt of payment of the registration fee in full.
• Participation is entirely at the participant’s own responsibility
• All participants have read the above and agree to all conditions of the event and accept that the Porsche Classic Club Belgium have acted in good faith and bear no liability.

I agree with the above conditions and would like to register for the event *