Fall Registration

Player's name

First

Last

Level of Participation

Player's date of birth

MM/DD/YYYY

What school does the player attend?

What class is the player in?

Grade School, Freshman, Sophomore, Junior, Senior, Graduate

Number of previous seasons played

Permission & Agreement

I give the player stated here permission to play in this intramural league pursuant to all the terms and regulations that apply.

What Player's the

I agree to the following charge:

Total

$0.00

Square

Card

Name on Card