Buggy Club Malintrat - Adhésions, BCM63 Malintrat

Personal informations

Do you already have a license for the current/previous year? *

Yes, i have a FFVRC License (French Federation of Radio Controlled Cars)

Without License or other License allowing the practice of the radio controlled car (IFMAR, EFRA, UFOLEP, BRCA, AECAR, DMC, FEPRA, FBA, ...)

License Number

Ligue

Club

Lastname *

Firstname *

Civility *

Birthdate *

Nationality *

Birth Department

Birth City *

Address (number, street type, and street name) *

Additional address (residence, building, floor, door)

Postal code *

City *

Country *

Email Address *

Phone *

Total: €0 including € PayPal Fee

I have read and accept the membership conditions (Read the conditions)