MSMSA
Masaryk International Medical Students Association
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MIMSA FUTSAL TOURNAMENT 2011 APPLICATION FORM
TEAM: _
PLAYERS:
Captain:	Phone:	
2:		
3:		
4:		
5:		
6:		
7:		
Please deliver this application form to MJMSA during office hours at the latest 24th November. Participation fee is:
- 100,-kc for MIMSA & ESN Cardholders
- 150,-kc for Non Cardholders Mmhnum 5 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)