Intramural Sports Program 

Basketball Roster
 Intramural Basketball Roster

Team Name_____________________________

Division: Men _______ Women _______

League: Pro _______Semi-Pro _______

Team captains are responsible for getting signature, medical consent form, and phone number for each player on the team. Medical consent forms must be filled out and turned in before a players is allowed to participate in an intramural activity.

Captain______________________________ X__________________________________

Address_______________________________________ Phone____________________
                                       Consent              Phone
Players (please print)         Form               Number                            Signature

__________________ ________ _________________ X______________________

__________________ ________ _________________ X______________________

__________________ ________ _________________ X______________________

__________________ ________ _________________ X______________________

__________________ ________ _________________ X______________________