Inschrijving MERLIJN 2009 Summer Endurance 15/08/2009

Your E-mail address :

Name :
First name :
Street : Number :
Zip code : City :
Country :
Phone :

Team or Club / Raceway :
Driver #1 :
Driver #2 :
Driver #3 :

Would you like to use a ProSlot PS4000-IMCA motor from the organisation?

Yes
No

Please specify car body and insert any comments :