OFFICIAL TEAM ROSTER FOR ALL-OHIO SUPER SIXTEEN SHOWCASE

 

 

FULL TEAM NAME:                                                                                                        AGE GROUP:  _____________ 

 

COACH:                                                                     ADDRESS: ____________________________________________  

 

CITY:                                                                                         STATE:                          ZIP CODE: _________________

 

HOME PHONE:  (            )                                                    WORK PHONE: (             ) _________________________  

 

JERSEY       #	PLAYER’S 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 Super Sixteen Showcase.  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 print this form, fill it out and return 1-2 weeks before event to All-Ohio Summer Basketball Program 3235 Oakland Hills Drive Pickerington, OH 43147

or fax to 614-868-7626 to ensure inclusion in program.

 

Super Sixteen Showcase  roster form