Tuesday, June 13 2:00 PM - Thursday, July 13, 2023 3:30 PM

American River Water Polo Club

Registration

Step 1 of 4

Summer 2023 High School Water Polo - Rio Americano

Biographical
Waiver
Fees
Payment
Receipt

Instructions: To become a American River member, please complete this 2-step registration form. On step 2 you will be asked for your credit card (Visa, MasterCard) information. Once you complete step 2 and submit the form, you are immediately eligible to participate.

Athlete Information:

* Starred fields are required

First Name *

Preferred (Nickname)

Middle Name

Last Name *

Create Password

Sex *

Female Male

Birth Date *

School *

Graduation Month/Year *

Grade

Phones

Home *

Work

Cell

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

T-Shirt Size *

[Adult]

XXL

[Youth]

Emergency Contact

Name *

Relation

Phone *

Name 2 *

Relation 2

Phone 2 *

Doctor:

Doctor Phone:

Referred by:

How found us / First marketing source?

Bumper Sticker

Friend

Newspaper

Other

Posters