Intramural Sign-up Form

5 on 5 Basketball League - TEAM Registration Form

Monday and Wednesday Evenings

Liability Waiver
Intramural Sports Liability Waiver (pdf)
Each participant must complete, save and submit the waiver as an attachment to thenderson2@cocc.edu before the first game. If you experience any problem viewing or filling out the PDF in your browser, try a different browser, or save the document to your computer then open it using the free Adobe Acrobat Reader.

Rules
League Rules (pdf)

Registration Form

Team Name*

Fee Information
League is free for all current COCC students and dually enrolled OSU-Cascades students. All other participants will be charged a $50.00 entry fee. Participants must pay upon registration! NO Team will be allowed to have more than one non-student on the roster. Team registration forms must be complete with a minimum of 8 participants on a roster to be accepted.

Team Roster
Note: Make sure you check this email address and the IM Basketball website for game times and schedule changes.

Team Captain:

Name*First and last name

Email Address*

Phone*

Player 2:

Player 2 Name*First and last name

Player 2 Email*

Player 2 Phone*

Player 3:

Player 3 Name*First and last name

Player 3 Email*

Player 3 Phone*

Player 4:

Player 4 Name*First and last name

Player 4 Email*

Player 4 Phone*

Player 5:

Player 5 NameFirst and last name

Player 5 Email

Player 5 Phone

Player 6:

Player 6 NameFirst and last name

Player 6 Email

Player 6 Phone

Player 7:

Player 7 NameFirst and last name

Player 7 Email

Player 7 Phone

Player 8:

Player 8 NameFirst and last name

Player 8 Email

Player 8 Phone

Player 9:

Player 9 NameFirst and last name

Player 9 Email

Player 9 Phone

Player 10:

Player 10 NameFirst and last name

Player 10 Email

Player 10 Phone

Signature Check Box

I agree

By checking this box, I state that I have read the league rules. As team captain I understand I am responsible for my team's conduct and for upholding league rules before, during and after games. I also understand that I am responsible for my team filling out and submitting liability waivers before the are able to participate.

If you have questions please contact:

Joshua Motenko,
Assistant Director of Club and Intramural Sports
jmotenko@cocc.edu or 541-383-7794