Dynamo Youth Water Polo Club - Online Registration

First Name *

Preferred (Nickname)

Middle Name

Last Name *

Create Password

Sex *

Female Male

Birth Date *

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

Left/Right-handed?

Left Right Both

My Main Facility: •

Dynamo Swim Club - Chamblee

Bogan Aquatic Center - Gwinnett

2024 Chamblee Facility Release •

Click here to read, download and print the 2024 Chamblee Facility Release. This form must be signed and returned to Coach Stu either by hand delivery (paper printout). All players who train at Chamblee and Gwinnett must read, download, and print the Chamblee Facility Release.

I agree to complete the 2024 Dynamo Chamblee Facility Release and to submit back to Coach Stu by paper.

SafeSport: Parent and athlete completion of the online course for SafeSport is required. This is part of the USA Water Polo annual membership renewal. •

Parent and athlete hereby confirm that we have already in completed the online course for SafeSport.

Parent and athlete hereby declare that we will complete the online course for SafeSport before practicing/competing.

T-Shirt Size (Unisex): •

Years water polo experience: •

Water Polo Position: •

What is your 100 yard Freestyle swim time (MM:SS)? •

If you live in Georgia, let us know which GWPL (USAWP = *) or GHSWPA (AWP) team you play for: •

Other

Turbo Swimsuit Size www.kap7.com/pages/sizing •

3XSmall

2XSmall

XSmall

Small

Medium

Large

XLarge

2XLarge

Dynamo Hat •

S/M

L/XL

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