Personal Data
Driver
co-Driver
Surname + Name:
Address:
ZIP-Code/Town:
Country:
Date and place of birth:
Home Phone no.:
Mobile Phone:
Faxnumber:
E-mail:
Clothing Size: (XXS-XXL):
No. Driving license:
No. Passport:
Passport Place and Date of Issue:
Club/team:
DATA of the CAR:
Marque:
Model:
Year of contruction:
Plate no.:
Cubic Capacity:
FIVA-cardnr.:
Insurance Company:
Insurance Policy no.
Member ASI No.:
HOTEL ACCOMODATION:
Single room
Twin room
Double room
Attach or separately submit: Copies of passports, driving license, proof of insurance; photograph of the car
Driver
co-Driver
Passport:
Driving License:
Proof of Insurance
Picture of the car:
At the order of the degree 196/2003 we communicate that the personal dates above mentioned will be used only for carrying out activities inherent to the event. Whenever requested - based on article 7, law 196/03 - the participant can have access to his personal dates, can ask to modify, cancel or not using them for any purpose by writing a registered letter to the association "La Sicilia dei Florio", Via Leopardi 78, 90144 Palermo, Italy.
23
rd
- 31
st
May 2010
