Friends of Frederick E. Samuel Foundation, Inc.
Clyde Frazier Jr.
SlamJam Women's Basketball
2472 Adam Clayton Powell Jr. Blvd.
New York, New York 10030
(212) 862-4216
(212) 491-3608 fax

BASKETBALL REGISTRATION ROSTER

Team Name:   Team Coach:
   Address:
   (Apt.#)
  
 Phone: (H):
   (B):
   (M):

We, the undersigned players here agree to play during the current season or until duly released by our Team Coach, with the ________________________________________ team and will render our best services while playing. We certify that we have given accurate information.

REGISTRATION LIMIT - 12 PLAYERS
NO. PLAYER NAME (Please print) FULL ADDRESS YEAR SCHOOL SIGNATURE
1          
2          
3          
4          
5          
6          
7          
8          
9          
10          
11          
12          
CERTIFICATION OF COACH: I, ____________________________________________do hereby certify that this information is accurate and that our players have been fully acquainted with the rules of the SLAMJAM Basketball League.