All-American Shoot-Out Application

Name____________________________________________________________________________

Home Address____________________________________________________________________

Phone(______)__________________ High School_____________________________________

Ht__________ Wt__________ ACT__________ SAT___________ Yr of HS Graduation______

Position____________________ E-Mail____________________ Shirt Size _____________

Volleyball Honors _____________________________________________________________

Which Shoot-out?     February 18, 2012 at Tarleton State University in Stephenville

    Parental Authorization: I hereby authorize Charles Jolley or his designee, to select a hospital and or doctor of his choice and authorize treatment if necessary. I will be responsible for all medical bills incurred as a result of illness or accident while the below applicant is at an All-American Shoot-Out except those bills covered by insurance.

   I hereby request that you accept the application for enrollment of the applicant for the All-American Shoot-Out. In consideration of your acceptance of this application, I hereby release Charles Jolley, All-American Shoot-out, and its employees from all claims on account of injuries, illness, or disease which may be sustained by the applicant while attending the All-American Shoot-Out, and agree to indemnify Coach Jolley, St. Edwards University, Navarro College, and the All-American Shoot-Out from any claims which may hereafter be presented by the applicant as a result thereof.

Applicant Signature____________________________________________ Date_____________

Parent/Guardian Signature______________________________________ Date_____________

Mail this form to:

Include a check for $50.

Those walking on the day of the shoot-out will be required to pay $60 cash or money order. Call Charles Jolley, Director, (817) 946-7421 to check on walk on space availability.