Nominative Entry Form

Club/Federation*
Head of delegation*
Address
Postal code
City/Town
Country*
Phone/Mobile
E-mail*
Coach I Team Manager
Coach II Doctor
Coach III Physiotherapist
Judge I Brevet
Judge II Brevet
Other guest:

ARRIVING IN ITALY:

Transport: Airport:
Arrival date: Departure date:
Arrival time: Departure time:
Flight no: Flight no:
Arrival Notes:
Do you need OC transfer from/to airport?
 YES NO
How many persons?
Tranfer Notes:

Nominative List P/G

Category: Discipline:

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Name: Date of Birth:


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