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WIRSA Registration - Payment Checkout
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WIRSA Team Registration
Team Information
Team Name
Please enter a team name
Division
Men
Women
College/University
Please enter a college/university name
Team Captain Information
First Name
Please enter a first name
Last Name
Please enter a last name
Email
Please enter a valid email
Phone
Please enter a valid phone
Team Roster
Number
Enter a number
First Name
Enter first name
Last Name
Enter last name
Year
1
2
3
4
5
GR
FC/Staff
Former collegiated varsity player?
Yes
No
Listed on 2022/2023 varsity basketball roster?
Yes
No
Remove Player
Total Players:
Note: Please insure there is at
mininum of 10 players
on the team.
Add Player
Coach Information
Coach 1
Please enter a coach name
Coach 2
Intramural Sports/Sport Club Coordinator Information
First Name
Please enter a coordinator first name
Last Name
Please enter a coordinator last name
Email
Please enter a valid email
Phone
Please enter a valid phone
Note: The payment details below include the registration fee, and a 3% processing fee.
Payment Summary
Registration Fee
Processing Fee
Total
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It seems something went wrong and your form submission failed. Please double-check your information to make sure that everything is correct. If this issue persists, please email
willemsj@uwgb.edu
.
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