Login
[[_text]]
JUNE 8-11, 2017
Reset Password
- [[item]]
Preparing realtime database, might take a while.
[[file.name]]
[[file.status]]
[[file.error]]
Upload Driver's License
Please crop the image
Customer Information
Remarks
Discounts
Reservation
[[heading]]
[[_computeWinTime(customer.winTime)]]
Contact Number: [[customer.contactNumber]]
Prize: [[customer.prize]]
Adrress: [[customer.address]]
Email: [[customer.emailAddress]]
Raffle Winners
E-Raffle
Congratulations!
[[customer.firstName]] [[customer.middleName]] [[customer.lastName]]
Birtdate: [[customer.birthdate]]
Address: [[customer.address]]
Contact Number: [[customer.contactNumber]]
E-mail: [[customer.emailAddress]]
Raffle Winners
Please set your device to landscape to take photo.
Thank you!
Customer registration is successful
HEAD TO HEAD TEST DRIVE WAIVER/RELEASE
I, [[customer.firstName]] [[customer.middleName]] [[customer.lastName]] , volunteer to test drive the
| [[item]] | ___________________________ |
| [[item]] | ___________________________ |
on {{_formatDate(customer.timestamp)}} during [[event.eventName]]
at [[event.eventLocation]] do hereby declares;
- That I bind myself to the test drive rules and regulations, and at all times strictly follow the directions of the assigned MMPC officer/dealer/ event marshals inside the test drive vehicle;
- That I will handle and operate the test drive vehicle assigned to me in a manner consistent with the care expected of a duly licensed driver, observing all traffic laws and regulations;
- That should the test drive vehicle incur any damage or loss resulting from my negligence or misuse while the same is in my use and/or custody, I shall shoulder the cost of the repair of the assigned vehicle and/or indemnify MMPC for the loss and/or damage, without prejudice to any further liability which MMPC might hold me for.
- That I shall indemnify, hold free and harmless MMPC and {{customer.testDriveDealer}} , their officers, stockholders, employees, representatives and/or agents from any and all claims, actions, suits, proceedings and liabilities of whatsoever nature with respect to any damages, injuries or losses of any kind that I may personally suffer, as well as any property damage or loss to a third party arising in connection with my participation in this event or from my use of the test drive vehicle, whether caused by negligence or otherwise, except for damages, injuries or losses arising directly from the gross negligence of MMPC; and
- I have read this Waiver/Release and have fully understood its contents, and I voluntarily and willingly executed this document with full knowledge and consent.
[[customer.firstName]] [[customer.middleName]] [[customer.lastName]]
License # [[customer.licenseNumber]]
Signature over Printed Name
RESERVATION FORM
Reference Number: [[customer.timestamp]]
Date: [[_formatDate(customer.timestamp)]]
Last Name: [[customer.lastName]]
Birthdate: [[customer.birthdate]]
Full Name: [[customer.firstName]]
Gender: [[customer.sex]]
Middle Name: [[customer.middleName]]
License Number: [[customer.licenseNumber]]
Contact Number: [[customer.contactNumber]]
Email Address: [[customer.emailAddress]]
Address: [[customer.address]]
Dealer: [[customer.testDriveDealer]]
Sales Executive:
Test Drive
| Units |
|---|
| [[item]] |
Head to Head Test Drive
| Units |
|---|
| [[item]] |
Discount
Total Discount: PHP
| Details | Amount | Coupon Number |
|---|---|---|
| [[item.discountType]] | PHP |
[[item.couponNumber]] |
Reservation
Company Name: [[customer.company]]
Paid Amount: PHP
OR Number:[[customer.OR]]
| Unit | Variant | Reservation Amount | Coupon Number | Discount |
|---|---|---|---|---|
| [[item.unit]] | [[item.variant]] | PHP |
[[item.couponNumber]] | PHP |
*Valid for 2 months from the date of issuance.
**Not valid with existing fleet transactions.
**Not valid with existing fleet transactions.
I, hereby certify that all information provided is true and correct.
[[customer.firstName]] [[customer.middleName]] [[customer.lastName]]
Customer Name and Signature
Date
MMPC Representative
Date
New Event
Awesome!
Event creation is successful
Mitsubishi Events
{{_computeUsername(email)}}
Internet connection lost/unstable, DO NOT close the browser.
This is not the page you are looking for.
Check the URL and try again.
Go to Home
Registration
JUNE 8-11, 2017