Unified Sports Roster Form
Please complete all information below:
School:
Check event you wish to enter (submit an entry for each event):
Sat., Mar. 31 at New Haven Field House
Sat., Apr. 7 at Glastonbury HS
Sat., Apr. 28 at Conard HS-West Hartford
Name
Athlete/
Partner
Date of
Birth
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Athlete
Partner
Name of Coach:
Coach's Cellphone:
Coach's e-mail:
CERTIFICATION
By checking this box the listed coach certifies that the students listed in the above Unified Sports Roster Form have satisfied the State Health Statutes and local regulations regarding physical examinations and are physically fit to participate in the tournament.
