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I, __________________________,
voluntarily assume all risks of injury while participating
in the Pro-Am Suburban Coalition basketball exhibition
sponsored by Xpert Officials Association, Oxon Hill
High School and founder Howard Hill, II. The possible
risks associated with participating include, but are
not limited to the following: muscle strain, muscle
tears, shin splints, broken bones, broken necks, loss
of any teeth, heat-related illnesses, abnormal heartbeats,
abnormal blood pressure, strokes, heart attacks or
any other related life threatening injury. I voluntarily
waive any and all claims of injury against Xpert Officials
Association, PGCPS, Oxon Hill High School, the Suburban
Coalition and it’s founder Howard Hill II and/or
staff.
I have carefully read and fully understand the
waiver agreement above and to prove I agree to league
terms and conditions I will truthfully fill-out
all necessary information needed below and sign
my signature and agree that in case of an emergency
or injury the league is not responsible.
Please PRINT CLEARLY after Signing Your Signature
HERE X_____________________
NAME: ____________________ D.O.B. ________________
ADDRESS: ________________________________________
CITY: ________________ STATE: ______ ZIP: _________
EMERGENCY NUMBER: ( ______) _______ -- __________
EMAIL ADDRESS: __________________________________
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