Washington Wetskins

Online Registration

Step 1 of 3

Biographical

Waiver

Payment

Receipt

Instructions To become a Washington Wetskins 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.

* Starred fields are required

First Name *
Preferred (Nickname)
Middle Name
Last Name *
Create Password

Sex * Female Male

Birth Date (mm/dd/yyyy)

Phone

Home/Primary
Work/Secondary
Cell/Other

Texting

Cell number to receive texts

Cell phone service provider

Street
Street 2
City
State
ZIP

USWP Number *		Exp. Date	(12/31/yyyy) USWP information/Sign-up
Left/Right-handed?	Left Right Both

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