MB II Water Polo
2017 Registration Form
One per player
Player Name:______________________________________________________
Address: _________________________________________________________
__________________________________________________________
Home Phone: __________________
Cell phone: ___________________
Player Age: ___________________
Birth Date: ___________________
T – Shirt Size: _________________
Sex:
M
F
Mother’s Name: ____________________________
Father’s Name:
____________________________
Email Address:
_________________________
PLAYER REGISTRATION $95
Make checks payable to Maplebrook II Swim & Racquet Club
Drop off forms by 5/15
Ginny Stablein – 400 Quail Drive Naperville, IL 60565
(630) 548 – 0423
[email protected]
Call or email with any questions.