Name
Country of residence
Postal code
City
Address
Business: (work, companies, main source of revenues)
Email address
Phone number (private)
Phone number (in case of emergency)
Your cars
Have you ever lost your driving licence? (when and for what reason)
What’s your insurance discount?
How many car accidents did you have? (in the last 5 years)
Did you ever have problems with car insurance? (refusal, price increase)
What’s your experience with high power cars? > 400 hp
Important qualification and experience (trainings, motorsport license)
Medical conditions (with influence on the ability to drive)
Detailed cars interests (what you’re into and how do you fulfill it)
What do you expect from the Club? (cars, activities, knowledge, networking etc.)
What can you offer to the Club? (your company’s offer, contacts, experience etc.)
Did you get recommended to the Club?
Contract and invoice data (company or personal)
Attach a scan / photo of your Driving License and ID Card
The application is valid only with a scan / photo of a valid Driving License and ID Card.
The administrator of personal data is Supercar Club Poland S.A. with its registered headquarter in 00-844 Warsaw at ul. Grzybowska 63. Providing data is voluntary, and the person providing the data has the right to access data, rectify data, limit processing, delete data, object to processing and the right to submit a complaint to the supervisory body for the protection of personal data. The basis for the processing of personal data provided in this application is voluntary consent, without which it is not possible to verify a candidate for membership in the Club.
PAfter conclusion of the contract with Supercar Club Poland S.A. the legal basis for basis for data processing is the realization of the contract. Personal data may be processed for the Administrator's marketing purposes (legitimate interest), against which an objection may be raised. To the extent that the data above is processed in order to perform the contract or is processed on the basis of consent - you also have the right to transfer data.
I hereby acknowledge and consent to Supercar Club Poland S.A. verified my insurance history in the field OC and AC insurance, claims, discounts / increases in insurance rates and determined which vehicles are currently and have been insured by me in the past. I also hereby consent to the verification by Supercar Club Poland S.A. my financial credibility by making inquiries with credit reference agencies as well as obtaining information on criminal records. I guarantee the accuracy of the information provided and agree to its verification
