Adhérer au Fan’s Club

First Name *

Surname *

Date of birth (day, month, year)*
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Address (street&number) *

Postal code *

Town *

Region/Province/District *

Nationality *

E-mail address *

Phone (if not italian, please specify the country code) *

Want to receive at home the club card & the complimentary gift? *
YesNo

Other requests or comments (optional)

I agree with the Fan Club statutes *

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