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2019 5th Grade Boys Flexx Registration and Uniform Payment Form

Welcome to Loudoun Flexx Basketball, the premier AAU/Travel club in Loudoun County. The program's primary focus is on teaching the proper fundamentals of basketball, teamwork, and sportsmanship. We believe in positive reinforcement to promote confidence and foster a love for the game of basketball. We are excited to have your player be a part of the Flexx family.

Each player will need to pay the $12.50 county participation fee in order to use the facilities. In addition, each uniform is $95 and includes high-end sublimated shorts and a jersey. Please pay the total of $107.50 via PayPal to LoudounFlexx@gmail.com . IMPORTANT: Since Flexx is not a corporation, please use the Pay a Friend option. Otherwise Flexx will be charged a 3% fee.

I being the parent of the player named below, hereby agree that I will hold the Loudoun FLEXX Basketball (“Flexx”) and its officers, directors, and coaches faultless in the event of injury or other harm occurring to the my child at any associated Flexx event, tryout, practice, games, or tournaments or at any such event that Flexx participates in. 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.

By clicking Yes below, I agree to the language above.

Player Full Name*

Player DOB*

Player Current Grade*

County of Residence*

Parent1 Email Address*

Parent1 Phone Number*

Parent2 Email Address*

Parent2 Phone Number*

Player Information/Experience

Uniform Jersey*

Uniform Shorts*

Preferred Jersey # (Two options please)*

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