Maroon Intramural Sports (MIS)

Participant Registration Form

Student: ________________________________________________________
Last name
First name
Middle Initial

Student ID _________________

Student email: _____________________________________ Student Cell #___________________________

List any medical conditions: _______________________________________________________________

_______________________________________________________________

List any medications taken: ________________________________________________________________

_______________________________________________________________________________________

Parents Name:
Mothers Name ________________________________________________________________
Phone: hm______________________cell______________________ work__________________________

Dads Name ___________________________________________________________________

Phone: hm _____________________ cell _____________________ work __________________________

Shirt Size: Adult

small

medium

large

X Large

XXL