ALL-OHIO SUMMER BASKETBALL PROGRAM

"AMERICA'S PREMIER BASKETBALL PROGRAM 2009"

 OFFICIAL TEAM ROSTER FOR MIDWEST FUTURE STARS SHOWDOWN AND SHOOTOUT 2009

 

FULL TEAM NAME:                                                                                                        AGE GROUP:  _____________ 

 

COACH:                                                                     ADDRESS: ____________________________________________  

 

CITY:                                                                                         STATE:                          ZIP CODE: _________________

 

HOME PHONE:  (            )                                                    WORK PHONE: (             ) _________________________  

 

 

JERSEY

      #

 

           PLAYERS NAME*

 

AGE

 

D.O.B.

 

 HT

 

                   SCHOOL

 

CURRENT

GRADE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I hereby certify that the members of team named above meet the age requirements stipulated by the All-Ohio Midwest Future Stars Basketball Tournament.  I also certify that each of the above named players is covered by a proper accident policy of insurance.  In consideration of your accepting this team roster, I hereby for myself, my team, heirs, executors, administrators, and assignees waive and release any and all damages incurred at said tournament.

 

 

            _____________________                     ____________________________________________________

               Date                                            Signature of Team Representative/Position with Team

 

 

            *Please type or print names legibly so they can be correct for college coaches.  Thank you!

 

Please return 1-2 weeks before event or fax to 614-868-7626 to ensure inclusion in program.