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3 ON 3 ON 3 Futsal Challenge

ENTRY FORM
Name of Institution Team 1 No 1 2 3 4 5 Team 2 No 1 2 3 4 5 Name of Team (if any) Name Date of Birth Student ID IC/ Passport Number Name of Team (if any) Name Date of Birth Student ID IC/ Passport Number

Team Manager Mobile Team 1 Captain Mobile Team 2 Captain Mobile


Entry to be sent back no later than February 29, 2012. Please keep a copy for your own record.

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