Monday, July 1 - Sunday, July 28, 2024

Bulldog Water Polo Club

Registration

Step 1 of 4

16/18u - July 2024

Biographical
Waiver
Fees
Payment
Payment
Registration Confirmation

* Starred fields are required

First Name *

Preferred (Nickname)

Last Name *

Create Password

Sex *

Female Male

Birth Date *

School

Cell Phone *

Texting Cell

Mobile provider

Email

Country *

Street *

Street 2

City *

State *

ZIP Code *

USWP Number *

Exp. Date

(12/31/yyyy) USA Water Polo information/Sign-up

USWP Club Name

Left/Right-handed?

Left Right Both

Parent/Guardian

Emergency Contact

Name *

Relation

Phone *

Name 2 *

Relation 2

Phone 2 *