You are registering for MS Water Polo - Admin Registration - FALL 2022

Registration Form created by Colby Smith

1. Please complete the on-line registration below.
2. This for the CV Middle School / Elementary School (MS/ES) program for the fall of 2022.
3. There will be a separate registration and payment process for the CV Community Aquatic Program (CVCAP) office -- details should be available in early September.
Thanks . . . Colby

25 registered

Player's Last Name*

Player's First Name*

Date of Birth (MM/DD/YYYY)*

Gender*

Grade in School (2022-2023 School Yr)*

School Attending (e.g., MV, WC, EV, SH, SpH, etc)*

T-Shirt Size (e.g., YM, YL, AS, AM, AL, etc)*

Parent's Name (Last, First)

Cell Phone 1 (format: 717-123-4567)

Cell Phone 2 (optional)

Address (street # and name, city, zip code)

Parent Email 1 (Required)*

Please re-enter the Parent Email 1 (Required)*

Send me a confirmation email (recommended)

Parent Email 2 (optional)

Please re-enter the Parent Email 2 (optional)

Allergies or Medical Information (optional)

Emergency Contact (First and Last Name, Phone Number)

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