Application for participation in: - Mercedes-Benz Clubs

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Privacy Statement: I herewith agree that the information collected within the context of this contact, can be processed and utilized by Daimler AG and its sales and service partners as well as Mercedes-Benz Museum GmbH to inform me and advise me on products and services of the Daimler Group and for the purpose of market research. For this purpose, Daimler AG may transfer this information to the appropriate dealer/service partner within the Daimler sales and service organisation and market research institutions. You may contact me ( ) by phone and fax ( ) by e-mail and SMS ( ) I prefer not to receive any information by mail If you wish to object to the processing and use of your information at a later date, please contact Mercedes-Benz Museum GmbH, “Privacy Protection” Mercedesstr. 100, D-70372 Stuttgart. Unfortunately, we can then no longer provide any assistance and information. Place, date _________________________ Signature ________________________ 2 / 4
1. Event / Organizer Additional Information Organizer is Mercedes-Benz Museum GmbH, 70567 Stuttgart (hereinafter called “organizer”). Only members of recognized Mercedes-Benz Clubs are eligible to participate (hereinafter called “participant(s)”). The event is an international, sportive, touristic, cultural, and societal meeting with Daimler, Benz, and Mercedes-Benz cars. It will take place between 21/4 – 25/4/2011 in accordance with the invitation subject to a possible later change by the organizer. The fee for participation (see Item 3) includes the following services: The event, “Mercedes-Benz & Friends. Mercédès – mon amour,” is a drive with vintage cars along the Cote d`Azur in combination with a trip aboard the cruise ship “Le Boreal” from 21/4 – 25/4/2011. The ship serves the guests as hospitality area after the drives. There is one double cabin (two separate beds is a possibility) per vehicle for the overnight stays. In addition, breakfast, lunch, and dinner including beverages (“open bar”), minibar, travel documents, guarded parking for the classic cars during the night at the open space at the port and at the day of transfer to Corsica are included in the fee, so is contacting a towing service during the journey and small repairs exclusive of any spare parts. During the 4 event days, the ship takes you for one day to the island of Corsica for shore excursions. The cities Marseille, St. Tropez, Nice, and Monaco are integrated into the event programme. 2. Deadline / Requirements of Participation / Confirmation of Participation The deadline for the application is 25 February 2011 The number of cars and participants is limited. By the end of February 2011, the organizer selects the participants among the received completed application documents. Participation is confirmed by 4 March 2011. By submitting the application, the applicant confirms: a) membership in a Mercedes-Benz Club b) that he or she has a valid driver’s license c) that the vehicle is properly registered d) liability insurance coverage of at least € 2.5 million for personal injuries and € 500,000.00 for property damages The organizer reserves the right to reject an application without stating any reasons. 3. Payment Terms In case, the participant receives confirmation, there is a participation fee in the amount of per vehicle including one driver and one passenger. € 1,900.00 3 / 4
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Application for participation in: - Mercedes-Benz Clubs

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