Campus Recreation : Ejection Reinstatement Form

Ejection Reinstatement Form

You have been ejected from an intramural game and have been suspended indefinitely from all intramural sports games and events. To regain eligibility for any further intramural play, you must complete the following form. Failure to complete this reinstatement procedure may result in additional suspensions from intramural games, Campus Recreation sponsored events, the Student Recreation Center and referral to the Office of Judicial Affairs.

Contact Information

Please make sure you have filled in all required fields with valid information.

First Name:

Last Name:

Email:

Phone:

- Phone (next 3 digits): - Phone (last 4 digits):

Team Captain Contact Information

Please make sure you have filled in all required fields with valid information.

Team Captain First Name:

Team Captain Last Name:

Team Captain Email:

Team Captain Phone:

- Phone (next 3 digits): - Phone (last 4 digits):

Written Statement and Availability

Please make sure you have filled in all required fields with valid information.

Prepare a written statement detailing the events surrounding your removal from the game:

Availability to meet with Intramural Sports staff?
(Mon-Thurs 12pm-6:30pm)