MAAF

registration form of: *


name and surname *


e-mail: *


tel. fix e/o cell:


To confirm registration, send deposit of 150 € on the bank transfer to: Account owner: La Terra Galleggiante - via Chiappero n ° 12 - 10064 Pinerolo. bank: BANCA PROSSIMA - IT28A0306909606100000005851 (BIC): BCITITMM entries that are not accompanied by account will be held in abeyance


copy of the receipt of payment (optional)


report any different sender of the bank transfer: