MIMSA FUTSAL TOURNAMENT 2010 APPLICATION FORM TEAM: _______________________ PLAYERS: Captain: Phone: 2: 3: 4: 5: 6: 7: Please deliver this application form to MIMSA during office hours at the latest 17th NOVEMBER. Participation fee is: - 100,-Kc for MIMSA & ESN CARDHOLDERS - 140,-Kc for NON CARDHOLDERS Minimum 5 Players / Maximum 7 Players NOTE: When not playing, each team must have a player to referee some games. Check www.mimsa.cz for more info (place, time, office hours)