Club Registration – NORTH IDAHO WATER POLO

Membership Information

You have selected the Trial Membership membership level.

This option will register a single player for a monthly trial membership, which is typically for Development players that are trying out the High School level.

The price for membership is $10.00 now.

Membership expires after 1 Month.

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Account Information

Username

Password

Confirm Password

First Name

Last Name

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

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Parent Information

Parent 1 Full Name

The full name of the player's parent (e.g. "John Doe")

Parent 2 Full Name

(Optional) The full name of another parent of the player (e.g. "Jane Doe")

Parent Phone Number

A phone number where one parent can be reached.

Acknowledge Photo Policy

We like to share the great things happening with our club, including player achievements and celebrations. Your player's likeness/name may be used on our Website, Social Media, and/or News Media. By checking this box you acknowledge that you understand the above, and that if you wish for your child's likeness/name to not be used you will need to contact Coach Collingham to sign the Photo Exemption Form.

Digital Signature Consent

By checking this option, you consent to using a digital signature for signing the waivers.

Player 1 Information

Player 1 Full Name

The full name of the player (e.g. "Jane Doe").

Player 1 Date of Birth

Used to determine the age of the player only.

Player 1 Email Address

(Optional) An email address for your player.

Player 1 Phone Number

(Optional) A phone number for your player.

Player 1 and Parent agree to the Code of Conduct Waiver

Please read the Code of Conduct Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Travel Waiver

Please read the Travel Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Liability Waiver

Please read the Liability Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Medical Waiver

Please read the Medical Release Waiver. Checking the box above acts as your digital signatures.

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