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Fall 2018 New Player Registration

Fall 2018 Try Water Polo New Player Registration
Please complete the following form. This form is required for insurance purposes for anyone entering the pool. Program and registration information will be provided at the Open House /Free Trial Practice. Thanks!
Email Address
Free Trial Practice Date



Player Name #1
Birth Date Player #1
Gender


Player #1 Swim Experience
Player Name #2
Birth Date Player #2
Gender


Player #2 Swim Experience
Address
Postal Code
Phone Number
Parent Name (if under 18)
Parent Email (if under 18)
Questions/Comments
I have read and accept the "WPS Personal Information Protection and Electronic Documents Act"(PIPEDA under Club Documents)


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