Yes the ball has to leave the centers hands so the QB has the ball then hands back off to the Center then the Center can run. This play can appear to look like a miss snap if not done properly, giving the defense an opportunity to stop the play before it can work. This is why you do not see Center keepers to often. In addition this is why you never see Center Keepers in a Shotgun formation
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no the quarter back doesnt have to touch the ball. just look at the wildcat made famous by the finns. their are also direct snaps