Ver 2020.2

Mercedes-Benz Club Victoria

www.mbcv.org.au

Concours d’Elegance 2020 - RegistrationSunday, 22nd March One registration form per vehicle. Maximum two vehicles per member Concours form only. No form required for Show and Shine.

Step 1: Pay Entry fee of $70 per vehicle using www.trybooking.com/BFYPQ bookings close 16 March 2020 - entries will not be accepted on the day of the event Step 2: Complete Form

Name(s) please underline surname

Note: your name must match that provided with your TryBooking.com payment

Address:

Telephone:

Email:

Vehicle details:

Year: …………… Model: …………………… Chassis Type: …….............. (e.g. C180, 280SE, 280SL) (e.g W201, W116, R107)

Colour: ……………………………………… Registration Number: ……………………...

Mileage: Actual odometer reading:

…………………km / miles Mileage claimed (for 5 digit odometers):

……………… km / miles

Body Style (tick one) Sedan/Saloon Coupé Roadster

Wagon/SUV Cabriolet Landaulet

Concours Class (A through to S, or U – subject to confirmation by Chief Judge)

Include in Restoration Class?

Yes (only tick this after reading the rules about restoration eligibility)

Include in Preservation Class?

Yes (only tick this after reading the rules about preservation eligibility)

Membership: State: ………………… Membership number: …………………………

I declare that, I am a financial member of a Mercedes-Benz Club; the registered owner of this car; the car has not been modified (except for entry into modified Class U) and I agree

to abide by the Concours d’Elegance Rules and Conditions of Entry.

Signed: ………Checking this box and emailing this registration form to the Club

This entry form, along with the rules and conditions of entry, can be downloaded from:

https://vic.mercedes-benz-clubs.com/concours-delegance/

Step 3: Once form is complete, please email it to concours@mbcv.org.au

Club use: Club member No: …………………. Trybooking payment confirmed

Date application Received …………….. Date Payment received………………….