2018 Charlie Hughes High School Tournament - Roster Submission

School Name *

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Roster - Player Only Needs to be Listed on One Roster

* All participants in the Charlie Hughes High School Shootout must be listed on a roster to be covered under the US Amateur Basketball liability insurance certificate. They DO NOT NEED TO BE LISTED on multiple rosters. If a JV player will play on a Varsity roster, his inclusion on the JV roster covers him.

MULTIPLE VARSITY OR JV TEAMS - Include ALL players on one roster! Example: If Fishers Red and Fishers White are TWO teams playing in the Varsity division, list all players on one roster. If you need more than 20 players listed, submit a 2nd roster and check the Additional players box.

Division for this roster *

Check this box if these are ADDITIONAL player(s) to a roster

Yes

List FULL names below:

Player 1 *

Player 2

Player 3

Player 4

Player 5

Player 6

Player 7

Player 8

Player 9

Player 10

Player 11

Player 12

Player 13

Player 14

Player 15

Player 16

Player 17

Player 18

Player 19

Player 20

Charlie Hughes Basketball, Inc. and the United State Amateur Basketball (USAB) Release of Liability and Parent/Guardian Consent: In consideration of accepting this application and for permitting the athlete to participate in activities organized by Charlie Hughes Basketball, Inc. and United States Amateur Basketball (USAB) and the athlete and the parent/guardian acknowledge that such activities (games, team practice, travel tournaments and so forth) expose the athlete to risk of injury, loss or death and the athlete and parent/guardian do hereby Release, Discharge, Hold Harmless and Agree Not to Sue or Seek Recovery from Charlie Hughes Basketball, Inc., USAB or the directors, officers, employees, volunteers, coaches and officials of either organization, or the facility, where the activities take place, and the employees, agents and representatives of such facilities, from any such claim arising from an injury, loss or death of the athlete from such activity. This release of liability includes, but limited to, the 2018 Charlie Hughes HS Basketball Shootout. (Sign by holding down left mouse button) *

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Typed Name in Signature Box *