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By clicking Yes below, I being the parent of the player named below, hereby agree that I will hold the Loudoun FLEXX Basketball and its officers and directors faultless in the event of injury or other harm occurring to the my child. By signing this “Waiver of Liability” I attest to the organizer, Loudoun Flexx Basketball, that adequate medical insurance is available for my child and that I am solely responsible for any medical expenses if necessary. *


Email Address*

Phone Number*

Player Full Name*

Player Current Grade*

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