Intramural Roster Change Request
DATE:_________________________________
TEAM NAME:__________________________
LEVEL OF PLAY:________________________
DIVISION:_____________________________
CAPTAIN’S NAME:______________________
DAY PHONE:___________________________
EMAIL ADDRESS:_______________________
PLAYERS TO BE ADDED TO YOUR TEAM
PLAYER'S NAME:___________________________________
EMAIL:____________________________________________
PHONE:___________________________________________
BIRTHDATE:_______________________________________
CSUCI STUDENT ID #:______________________________
You must include a Player Registration Form with this Roster Change Request in order to
ADD new players during the season.
PLAYERS TO BE DROPPED FROM YOUR TEAM
PLAYER'S NAME:___________________________________
EMAIL:____________________________________________
PHONE:___________________________________________
BIRTHDATE:_______________________________________
CSUCI STUDENT ID #:______________________________
Reason Player is Dropping:_______________________________________________________
___________________________________________________________________________
___________________________________________________________________________
CAMPUS REC STAFF APPROVAL:
DATE:
Recreational
Open
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