Rallye For Veterans · Become a Navigator

Service Information

Veterans Name

*

First Name

Last Name

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Cell Phone

Email

*

Verify Email

*

Rank

*

Service Status

*

Branch of Service

*

Era of Service

*

Select all that apply

WW II (1941-1945)

Korea (1950-1953)

Vietnam (1962-1973)

Gulf War (1990-1991)

Operation Enduring Freedom (2001-present)

Operation Iraqi Freedom (2003-2011)

Are you a member of any Veteran Service Organizations?

*

Disability Information

I am limited in mobility due to service-connected disability

I have a service animal that will be with me on the trip

Are there any trigger words and/or situations that have a strong effect on your PTS (if applicable)?

*

Please list any physical limitations so we can attempt to accommodate as best we can:

Each veteran/navigator will be required to ride as a passenger in a car and perform “typical” rallye navigator duties including: opening navigator’s envelope, holding up transponder at start/finish, handling, reading, interpreting rules, clues, and directions. Please remember, drivers are bringing their personally owned vehicles and these cannot be retrofitted in anyway.

What is your level of rallye experience?

*

Please list any dietary and/or environmental restrictions or allergies

Please provide additional information on accommodations

Proof of Service

DD214 (preferred) or Proof of Service letter or discharge papers

Identification

Copy of Driver’s License or other form of Government issued ID

Medical Documentation

VA ratings sheet and VA Ratings Breakdown (preferred) or MEB/PEB ﬁndings