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ARRE TRIAL CLASSIC - 27 MARS 2022
Inscriptions à l'épreuve
* Indicates required question
Email
*
Your email
NOM
*
Your answer
PRENOM
*
Your answer
DATE DE NAISSANCE
*
MM
/
DD
/
YYYY
LIEU DE NAISSANCE
*
Your answer
ADRESSE
*
Your answer
CODE POSTAL
*
Your answer
VILLE
*
Your answer
LICENCE FFM type
*
NTR
MAT
LICENCE MANIFESTATION SUR SITE FFM
LICENCE MANIFESTATION SUR PLACE
Required
NUMERO DE LICENCE
Your answer
MARQUE MOTO
*
Choose
AERMACHI
AJS
ARIEL
BETA
BIANCHI
BMW
BPS
BSA
BULTACO
BUTLER
CAPRIOLO
DELTA
DOT
DUCATI
FANTIC
FRANCIS BARNETT
GARELLI
GILERA
GNOME RHONE
GREEVES
GUILLER
HONDA
ITALJET
JAMES
JCM
KAWASAKI
MATCHLESS
MERLIN
MONTESSA
MOTO GUZZI
MOTOBECANE
MOTOCONFORT
NORIEL
OSSA
PARILLA
PCL
PEUGEOT
ROYAL ENFIELD
SUZUKI
SWM
TERROT
TRIUMPH
VELOCETTE
YAMAHA
ZUNDAP
TYPE
Your answer
CYLINDREE
Your answer
ANNEE
Your answer
CATEGORIES
*
LOISIR VINTAGE PRE 65 (jaune)
LOISIR VINTAGE PRE 80 (jaune)
LOISIR VINTAGE POST 80 (jaune)
CRITERIUM PRE 65 (vert)
CRITERIUM PRE 80 ( vert)
CRITERIUM POST 80 (vert)
NATIONAL PRE 65 ( bleue)
NATIONAL PRE 80 (bleue)
NATIONAL POST 80 (bleue)
INTER ( rouge)
NUMERO DE TELEPHONE
*
Your answer
ENGAGEMENT TRIAL
*
ENGAGEMENT 40 €
Required
REPAS DU SAMEDI SOIR 20 €
Choose
1 REPAS
2 REPAS
3 REPAS
4 REPAS
5 REPAS
6 REPAS
7 REPAS
8 REPAS
COORDONNEES POUR L'ENVOIE DES CHEQUES
TARIF ENGAGEMENT 40 € (REPAS DU SAMEDI SOIR 20 €)
CHEQUE à l'ordre du MOTO CLUB PAYS VIGANAIS
à retourner à SAUVAIRE RICHARD 13 BOULEVARD DES CHATAIGNIERS 30120 LE VIGAN
Téléphone 06 25 43 61 09 mail:
motoclubpaysviganais@gmail.com
A copy of your responses will be emailed to the address you provided.
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