Intramural Sports Team Entry Form

Sport:

Team Name:

League:

Division:

Manager's Name:

Phone:

E-mail:

Available Times:

Please select the times that your team can play. Intramural play begins after 6 p.m. each day. Teams must be available to play on the days specified for the division that they entered.

Please note that these are your preferred game times. Due to limited facility space, games will be scheduled as needed but we will do our best to schedule the majority of your games within the times you have chosen.

Mon Tue Wed Thur Sun

Each team member must read the Agreement and Release of Liability provided below. By adding their name to the roster list below, they are indicating that they have read, understand and agree with the provisions contained within the statement. Participants are highly encouraged to carry adequate health and dental insurance.

Agreement And Release Of Liability

  1. In consideration of being allowed to participate in the activities and programs of Northern Michigan University (NMU) and to use its facilities and equipment, and in addition to the payment of a fee or charge, if any, I excuse, release and forever discharge NMU, its officers, agents, employees, and representatives and any others acting on their behalf (the “releasees”) from any and all responsibilities or liability for injuries or damages resulting from my participation in any activities or my use of equipment in NMU’s facilities. I also release the releasees from any responsibility or liability for injury or damage to myself, including that caused by the negligent act(s) or omission(s) of releasees or in any way arising out of or connected with my participation in any activities of NMU or the use of any equipment at NMU.
  2. I understand that strength, flexibility, and aerobic exercises, and the use of equipment, pools, and saunas are potentially hazardous. The inherent risks include muscle soreness, exhaustion, dehydration, injury, fainting, falls, muscle and ligament injury, bone fracture, seizure, heart attack, drowning and death. I am voluntarily participating in these activities and using equipment, pools, and/or saunas with knowledge of the dangers involved. I hereby agree to assume and expressly accept any and all risks of injury or death.
  3. I am not suffering from any conditions, impairment, disease, or other infirmity that would prevent my safe participation in any of the activities or programs of NMU in which I will be involved or that would prevent my use of the equipment, pools, or saunas of NMU. I have been informed of the advisability of obtaining a physician’s approval for my participation in exercise/fitness activities or in the use of exercise equipment. I also acknowledge that it has been recommended that I have a yearly or more frequent physical examination and consultation with my physician as to physical activity, exercise and use of exercise and training equipment so that I might have recommendations concerning these fitness activities and equipment use. I acknowledge that I have either had a physical examination and have been given my physician’s permission to participate, or that I have decided to participate in exercise activities and/or use of equipment without the approval of my physician. I assume all responsibility for my participation in these activities.

Roster

Name:

 

Eligibility Statement

I have obtained a copy of the Intramural Sports Handbook, carefully read and understand the policies governing intramural participation and the eligibility requirements governing participation. In doing so, I have checked the eligibility of all players on my team and certify that each player meets each eligibility requirement to the best of my knowledge. I accept full responsibility for any error or discrepancy associated with the eligibility of the players on my team. I understand that failure to adhere to these requirements may result in the forfeiture of games, suspension of playing privileges, and possible expulsion from league play or disciplinary action as outlined in the rules established for competitive play.

Forfeit Policy

I have read and fully understand the forfeit policy as outlined in the Intramural Sports Handbook. I also understand that all forfeit fees assessed to my team are my responsibility and that those fees will be charged to my student account should they not be paid in accordance with the forfeit policy. I can avoid the forfeit fee by calling the Intramural Sports Office at 227-1692 at least 48 hours prior to game time. (Forfeit fee is $25.)

Managers Name: