Hoveround Lightning Quad Rugby
                                                                World's Greatest Wheelchair Sport

    USQRA Atlantic Coast Sectional Roster

        Checks payable to:  Suncoast Wheelchair Athletic Association

Team Name:_______________________________ Contact:______________________

Phone:___________________________ email:_________________________________

Coach:__________________________ Team Colors:___________________________

Players’  Name                            Classification         Jersey #              Shirt size

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Support Staff (3 allowed):___________________________________________________

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Sponsors:_______________________________________________________________

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            More than 12 total people per team will be charged at $50.00 per person.

                        Hoveround Lightning • 5593 Cedar Oak Blvd. • Sarasota, Florida  34233
                                    Phone/Fax: (941) 924-1804 • edandcindy@comcast.net