Registration

Click here for a printable Registration Form.

Step 1: Complete Form

*-required fields

Session*: Level*:
Athlete's Full Name*:
Athlete's Gender*:
Address:
City (CA):
Zip:
Home Phone* (000)000-0000:
Athlete's Cell (000)000-0000:
Mother's Name:
Mother's Cell (000)000-0000:
Father's Name:
Father's Cell (000)000-0000:
Athlete's Email*:
Parent's Email*:
Birthday* (Month/Day/Year):
Age on August 1, 2012*:
School:
Grade* (2011-2012 school year):
Insurance Release
To Whom It May Concern:
My child is a member of Foothill Club Water Polo and in the event of an injury or illness, I * as legal guardian, hereby grant my permission for * to be treated by a qualified and licensed physician in the event that immediate treatment is necessary. Permission for treatment is only authorized in the event that I am unable to be reached following a reasonable effort to do so. This permission is granted for the period of time beginning 2/20/2012 through 5/13/2012.
 *I have read and agree to the release above. Sign*:
Date*:
USWP Registration:
USWP-Current Member ID:
Expires:

<--Click Send to complete Step 1

Step 2: Pay registration fee – Online (click link)
(Payment Receipt will be emailed to you upon completion of this step)
*No refunds will be given beyond the first two weeks of the session

Step 3: Print out Payment Receipt and bring to practice
*If paying by check, please bring check along with the completed Registration Form to practice
*Athlete must provide proof of payment before entering the pool

**After the first two weeks of the session, there will be no refunds given**