Trieste Opicina Historic 2K19
Scheda di iscrizione - entry form
6-7-aprile 2019
Pilota - Driver
COGNOME - SURNAME *
Your answer
NOME - NAME *
Your answer
DATA DI NASCITA - DATE OF BIRTHOME - NAME *
Your answer
INDIRIZZO - ADRESS *
Your answer
CITTA’ - CITY *
Your answer
STATO - STATE *
Your answer
MOBILE *
Your answer
EMAIL *
Your answer
PATENTE N. - DRIVING LICENCE N. *
Your answer
SCADENZA - VALID THROUGH *
Your answer
TESSERA ASI - ONLY ITLIAN
Your answer
CLUB *
Your answer
AACC
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KCC
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NAVIGATORE - CO-DRIVER
COGNOME - SURNAME *
Your answer
NOME - NAME *
Your answer
DATA DI NASCITA - DATE OF BIRTH *
Your answer
INDIRIZZO - ADRESS *
Your answer
CITTA’ - CITY *
Your answer
STATO - STATE *
Your answer
MOBILE *
Your answer
EMAIL *
Your answer
VETTURA - CAR
MARCA - MAKE *
Your answer
MODELLO - MODEL *
Your answer
ANNO - YEAR *
Your answer
TARGA - REGISTRATION NR. *
Your answer
C.I. ASI - FIVA CARD
Your answer
ASSICURAZIONE - INSURANCE *
Your answer
POLIZZA N. - CERTIFICATE NR. *
Your answer
SCADENZA - VALID THRPOUGH *
Your answer
Partecipazione alla (selezione Scegli): *
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