Riverside Water Polo

Online Registration

Step 1 of 3

Biographical
Waiver
Payment
Receipt

Welcome to Riverside Water Polo!!!

To join our team, please follow these instructions:

1) If you are not currently a member of USA Water Polo please click on the link that applies to you:

Year Round Athlete: *(Please affiliate with our club #241)* USA Water Polo Registration
Splash Ball, Swim Fit or Swim Lessons: Click here (Please select "Riverside Swim Fit/Splash Ball")

2) To finalize your registration, please complete this online registration form. You will be asked to provide a credit card for payment. Please note that this online entry system helps Riverside Water Polo expedite new member and renewing member registrations. It provides members a way to easily update their information in our data base. This is a secure system so there is no risk to you.

Thank you and welcome to Riverside Water Polo!!!

PLAYER INFORMATION:

* Starred fields are required

First Name *

Preferred (Nickname)

Middle Name

Last Name *

Create Password

Sex *

Female Male

Birth Date *

School *

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) USWP information/Sign-up

Left/Right-handed?

Left Right Both

Parent/Guardian *

Emergency Contact

Name *

Relation

Phone *

Name 2 *

Relation 2

Phone 2 *