Minor

Major

This section for team sports only

Captain

Team Name

This certifies that I, as acting team captain, had each and every team member read and sign the waiver statement on the reverse side of this form. Also as team captain, I understand that it is my responsibility to inform the team members listed below of all rules and regulations enforced by the Intramural Office.
Captain’s Signature (type name then check box)

Type Name

Verify

Team Sports Roster

In this area type the name, student number, phone number, sex and E-mail address of all team members.

Example

1. Bill Smith
12345678
(321) 555-5555
male
billsmith@fit.edu

NOTE: INCOMPLETE FORMS WILL NOT BE ACCEPTED AT THE INTRAMURAL OFFICE
CONSENT FORM
I hereby acknowledge that participation in sports activities organized by the Florida Tech Intramural Office involves risk of injury, minor or serious, including permanent disability. These types of injury may result from my own actions, the actions of others or a combination of both.
I hereby forever waive, quitclaim and release any claims of any nature that I, or anyone claiming by, through or under me, may have at any time against Florida Institute of Technology Inc., its employees, officers or agents arising directly or indirectly, out of my participation in such sports activities, including but not limited to any claims arising out of the act or negligence of Florida Institute of Technology Inc. or its officers, employees or agents.
I consent to participate acknowledging all the foregoing risks.

Type Name

Verify