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European 2005 - Entry Form
European 2005
Race Rules Technical Rules Entry Form Report Results Photo Video
 

 

  See and download  (Pdf format)
 
 
 
via Guglielmo Marconi n°18
33010 Reana del Rojale (UD) - Italy
Tel. / Fax 0039 - 0432 – 857504
MODULO ISCRIZIONE / ENTRY FORM / BORDEREAU
 
 
3° Campionato Europeo Auto a Pedali
3rd European Championship of Pedal Car
3eme Championnat Européenne de la Voiture a Pédalier
 
Autodromo Nazionale di Monza – Giugno 2005
 
Nazione / Country / Nation         ____________________________________________________
 
Nome Squadra / Team Name / Nom Club          ________________________________________
 
Responsabile Squadra / Team Manager / Responsable du Club         _________________________
 
E-Mail         ___________________________________________________________________
 
Indirizzo / Address / Adresse         __________________________________________________
 
_______________________________________________________________________
                                              
_______________________________________________________________________
                                                       
Tel.   ______________________________             Fax          ___________________________
 
 
Nomi Piloti / Driver Names / Nom Pilote ---- Data di nascita / Birth date / Date de naissance
 
1        ______________________________________________         ________________
2       ______________________________________________         ________________
3       ______________________________________________         ________________
4       ______________________________________________         ________________
Numero totale componenti team (compreso staff)
Total number of Team  components (includine staff)
Le numérote total des composants de l'équipe (staff compris)                  ________________
 
Inviare questa pagina al Karbyk Official Team (vedi intestazione) prima del 15 Aprile 2005
To send this page to the Karbyk Official Team (you see heading) before April 15th 2005
Envoyer cette page au Karbyk Official Team (tu vois en-tête) d'ici le 15 Avril 2005