Register for SouthAmeriCar 2023

Thank you for your interest in our SouthAmericar trip. You can register via this form. If you have any questions, please call +31 73 610 62 04 or send an e-mail to info@sapapanatravel.nl.

The participation costs are € 3.650 per team (10% of the travel sum). This is also the first down payment for the trip. After receiving the registration fee, the registration form will be processed. Transfer your registration fee to: Sapa Pana Travel NL49RABO0155200046 incl. SouthAmeriCar 2022 and your name. The entry fee will not be refunded unless Sapa Pana Travel decides that this trip cannot take place.

Your personal information

Salutation *

First name *

Last Name *

E-mail *

Phone number *

Date of birth *

Your contact details

Address *

Postal code *

Residence *

Details passenger

Salutation

First name

Last name

E-mail

Phone number

Date of birth

Contact details passenger

Adress

Postal code

Residence

Car details

Membership

Membership number

Brand of the car

Brand of the motor

Number of cylinders

License plate number

Date 1st registration

Chassis number

Color

Value of the car in €

Weight of the car

Owner of the car

Comments or questions

* Fields with an asterisk are required.