Oakwood Water Polo Club
Spring Athlete Registration Form 2017
Dates: February 27 – May 25, 2017 Times: 6:30 – 8:00 pm
Monday, Tuesday & Thursday 8th. Grade & under - Boys & Girls
High School age groups (if you are not swimming for your high school)
All members must be Registered with USAWP - Oakwood Water Polo #20514
Please provide us with your current 2017 USAWP membership Number
Athlete’s Name: ______________________________________________________
Parent’s Names: ______________________________________________________
Address: ____________________________________________________________
City / Zip: ___________________________________________________________
Home Phone Number: _______________________cell:_______________________
E-mail address: _______________________________________________________
Date of Birth: _____________________
Age: _________________
USAWP Membership Number: ________________
Expiration Date: __________
Level of Membership: Bronze ______ Silver_____ Gold ____
Emergency Contact_________________________Phone_____________________
Early Registration Fee, $300 if paid in full by Feb. 17th. ($100 discount)
Early Registration Fee, $350 if paid in full by Feb. 24th. ($ 50 discount)
Registration fee: $400, after Feb. 24th.
(if necessary, you can split into 2 payments - $200 - $200)
*Two checks due at time of registration (one postdated for March 20th.)
Please go to “oakwoodwaterpolo.org “
to complete & submit your registration, electronicly.
You can mail payment to address provided below
To be filled in by OWP Staff:
Paid _____ Check# _____ Cash _____
USA Card_____ Med Release_____ Code of Ethics_____
Submit with check payable to:
Oakwood Water Polo Club, 932 Oak St., Brentwood, CA 94513