Entry Form ItaliaRun 2010

Mr. Mrs.Ms.
Surname:

First name:

E-mail:

Telephone:

City:

Country:



First passenger (optional)

Mr. Mrs.Ms.
Surname:

First name:



Second passenger (optional)

Mr. Mrs.Ms.
Surname:

First name:



Car details

Make and model:

Year:

License plate:



On this page you can enter the Italia Run 2010.
Participation is limited to 20 cars.

In case you wish to receive additional information, please send an e-mail to info@italiarun.nl.