Tuesday, September 3 - Saturday, November 30, 2024
Orange County Water Polo Club
Registration
Step 1 of 4
12/U GIRLS FALL Registration
Biographical
Waiver
Fees
Payment
Payment
Receipt
* Starred fields are required
First Name
*
Preferred
(Nickname)
Middle Name
Last Name
*
Create Password
Sex
*
Female
Male
Birth Date
*
School
*
Graduation Month/Year
*
Phones
Home
*
Work
Cell
Texting Cell
Same as Cell Number
Mobile provider
Choose...
Alltel
AT&T
Boost
Cricket
Google Fi
MetroPCS
Mint
Nextel
Other
Rogers
Sprint
T-Mobile
Ting
TracFone
US Cellular
Verizon
Virgin
Add Another Texting Cell Number
Email
*
Label
Email
Label
Email
Label
Email
Label
Email
Label
Email
Label
Add Another Email Address
Country
*
Select One
United States
Afghanistan
Albania
Algeria
American Samoa (US)
Andorra
Angola
Anguilla (UK)
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda (UK)
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands (UK)
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands (UK)
Central African Republic
Chad
Chile
China
Christmas Island (AU)
Cocos (Keeling) Islands (AU)
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands (NZ)
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (UK)
Faroe Islands (DK)
Fiji
Finland
France2
French Guiana (FR)
French Polynesia (FR)
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar (UK)
Greece
Greenland (DK)
Grenada
Guadeloupe (FR)
Guam (US)
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Holy See (Vatican City)
Honduras
Hong Kong (CN)
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic (North)
Korea, Republic of (South)
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau (CN)
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique (FR)
Mauritania
Mauritius
Mayotte (FR)
Mexico
Micronesia, Federated States of
Moldova Republic of
Monaco
Mongolia
Montenegro
Montserrat (UK)
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles (NL)
New Caledonia (FR)
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island (AU)
Northern Mariana Islands (US)
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands (UK)
Poland
Portugal
Puerto Rico (US)
Qatar
Reunion (FR)
Romania
Russia
Rwanda
Saint Helena (UK)
Saint Kitts and Nevis
Saint Lucia
Saint Pierre & Miquelon (FR)
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia & South Sandwich Islands (UK)
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands (UK)
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands (US)
Wallis and Futuna (FR)
Western Sahara
Yemen
Zambia
Zimbabwe
Street
*
Street 2
City
*
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Choose...
Australian Capital Territory
Jervis Bay Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
ZIP Code
*
USWP Number
*
Exp. Date
(12/31/yyyy)
USA Water Polo information/Sign-up
USWP Club Name
Left/Right-handed?
Left
Right
Both
T-Shirt Size
[Adult]
S
M
L
XL
XXL
Parent/Guardian
*
Emergency Contact
Name
*
Relation
Phone
*
Name 2
*
Relation 2
Phone 2
*
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