Intramural Sports Team Registrat

Intramural Sports Team Registration Form

University of Hartford Intramurals

Office Use Only

Team Name

Sports

Division

Special request for scheduling (This is not guaranteed but we'll try our best to meet your needs.)

(Writing down "No Thursday" so you can go out is not an acceptable excuse!)

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Blackout Dates: (Dates and times that you are positive you cannot field a team. Accommodations are not guaranteed.)

(Ex. Holidays, Special Events etc.)

This Certifies that I, (team captain/ Manager), know and understand the eligibility rules and have completely checked the eligibility of all the

Players on my team. If there is any discrepancy, I will assume full responsibility. I understand that failure to comply with these rules will result in action as outlined in the Intramural

Handbook and the rule packets.

Team Captain Name Signature

(Type your initials as a Signature)

Local Phone Date

Work Phone/ Cell Phone SSN#

Local/ School Address

E-mail Address

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Assistant Captain Name

Local Phone

Work Phone/ Cell Phone SSN#

Local/ School Address

E-mail Address

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** This is not an assumption of risk form**

All players will be required to sign the assumption of risk form participating in their first game.