La Mitica CICLOSTORICA - CASTELLANIA - 1 / 2 LUGLIO 2017

CICLOSTORICA CON BICI D'EPOCA PER I COLLI DI SERSE E FAUSTO COPPI

    MODULO ISCRIZIONE

    Compila il presente modulo e premi il tasto Invia. Successivamente ricordati di inviare via mail a info@lamitica.it la ricevuta del pagamento effettuato tramite bonifico bancario intestato a: A.P.S. I COLLI DI COPPI presso Banca Centropadana - Credito Cooperativo S.C.R.L. Corso Alessandria, 39 - 15057 Tortona (AL) IBAN: IT37Y0832448670000000215512 SWIFT: ICRAITRR900 Non saranno ritenute valide le iscrizioni senza relativa ricevuta di pagamento.
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    DATI PERSONALI

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