Bronco Pride - Black horses as bookends

INTRAMURAL BASKETBALL
Team Registration Form

Fayetteville State University is not responsible for injuries incurred in intramural activity.  

Basketball player in yellow dribbling a ball.It is strongly recommended that all participants have satisfactory health status and appropriate accident insurance coverage for any injury which might occur during intramural participation.

Team members should complete the information requested in the spaces provided below:

Team Name: 

Coach:    Address:

Phone:

Captain:    Address:  

Phone:

 Team Roster - One Name to a Box:

1.                     2.

3.                     4.

5.                     6.

7.                     8.

9.                     10.

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