Form 3A

FORM 3A

Florida Half Century ASA, Inc.

TEMPORARY PICKUP

Tournament Host _____________________________________________________

Location ______________________________________ Dates ________________

Please ADD the following player (s) to the roster submitted for:

Team ______________________________ Area ________ Seed Division _______

Player Team Seed FHCA Number________________

1. __________________________________________________________________

2.___________________________________________________________________

3.___________________________________________________________________

NOTES:

1. A player may only be a pick-up four times during the calendar year.

2. Teams may pickup a maximum of 3 players, but only one player from a higher division.

3. Pickup players MUST be from the same geographical area.

4. Players making a roster change, (permanently moving to another team), must complete Form 3B, Player Roster Change Form, before playing in a tournament.

Signature of the Team Manager __________________________________________

Form 3A - Revises 10-13-03