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Modulo Iscrizioni 6° Trofeo
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CONCORRENTE 1 - CONDUTTORE
Cognome
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Nome
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Email
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Codice Fiscale
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Via
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Cap
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Città
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Telefono/Fax
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Patente n°
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Scadenza Patente
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MM
/
DD
/
YYYY
Tessera ACI n°
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N° di Licenza ACI SPORT
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Scadenza certificato medico
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MM
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DD
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YYYY
Taglia
Secondo disponibilità
XS
S
M
L
XL
XXL
Misura
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S
M
L
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XXL
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