SoAC Water Polo Club
Fall/Winter League 2016-17
Registration now open!
Ages: 8-12 & 14-18
Season Dates: 11/16 - 1/29
SEASON FEE: $295.00 /$245**
SoAC is a USA Water Polo program for all ages and abilities. We strive to create a program that teaches water polo
fundamentals, in an environment that develops character, self-esteem, team work, the competitive spirit, and a strong
work ethic in all aspects of life.
Ask about our payment plans! Payment plan available $148 first payment $147 second payment.
(MUST have valid credit card on file to be eligible for payment plan see back for info)
Registration will be taken at the parent meeting and on the first day of practice. During other times registration
can be done online* www.unioncity.org or at our community centers. *online registration includes additional service fee.
Parent Meeting: Thursday , November 10th Time: 7:00pm
Location: Ruggieri Senior Center 33997 Alvarado Niles Union City 94587
LOCATION: DAN ODEN SWIM COMPLEX 33901 Syracuse Ave Union City 94587
Girl’s Practice Times CODE: 64882
Tuesday’s & Thursday’s: Girls 18U, 16U, 14U 6:30-9:00pm
Sunday: 18U, 16U, 14U 12:30-2:30pm
Boy’s Practice Times CODE: 64883
Monday’s & Wednesday’s: 18U, 16U, 14U 6:30-9:00pm
Sunday’s: 18U, 16U, 14U 9:30-11:30am
Athletes must also obtain a USA WATER POLO Membership within the first week of practice. www.usawaterpolo.org.
This is a separate fee paid to USA WATER POLO. Visit website for details.
Under 12’s Practice Times: FEE: $ 240** GIRLS: 64888
BOYS: 64889
Thursday’s: 12U Girls 6:30-8:00pm12U Wednesday’s: 12U Boys 6:30-8:00pm
Sunday’s: Boys and Girls 11:15-12:45pm **U 12 only practice 2 times per week
Contact Precious Gerardo at [email protected] for more information Or call 510-675-5486.
More registration info on back.
Players Full Name_______________________________________________ Birthdate _____/____/_____
Address: _____________________________________________________Apt. #_____________
City:_________________________________ Zip ______________________
Phone___________________________________
Mobile Phone __________________________
E-mail_____________________________________________________
Practice Code: _____________
I,the undersigned, agree to indemnify and hold harmless the City of Union City from any loss or liability which is alleged to have resulted from my participation in this program. I have read and understand the activity description listed in the Union City Leisure Services Department Activity Guide, and I comprehend all the risks involved by participating in that activity. I hereby give my dependents
permission to participate in the activities indicated and absolve the City of Union City, its employees, volunteers, contractors and
officers from liability. I also grant full permission to any and all of the foregoing to use my name and any photographs, videos, motion
pictures or recordings for any publicity and promotion purposes without obligation or liability to me.
Parent or Guardian Full Name (please print)________________________________________________________
SIGNATURE____________________________________ Date_________ Circle one) : Parent / Guardian / Participant
Withdrawal/Refund/Pro-rate Policy: After the first day of practice no refunds will be issued due to scheduling conflicts. NO EXCEPTIONS. Before the first day all withdrawals a $25.00 processing fee will be applied.
If your child becomes ill or hurt and cannot participate for half or more of the season, a doctors note is required for refunds. These will only be processed in person at the Ruggieri Senior Center. Pro-rated plans
must be approved by Erin Ewing, the SOAC Admin & Aquatics Coordinator ONLY before being issued. Sibling discount does not apply for Pro-rated season.
Payment Plan Authorization Form
I hereby authorize the Union City Community & Recreation Services Department to charge my credit card for the 2 nd
payment of SoAC Waterpolo club fees and/or remaining balance on my Union City Community & Recreation Account.
Services account in the amount of: $___________________ on or after Monday Feb 6th 2017.
Type of credit card (circle one): Discover
MasterCard
Visa
Card Number: _____________________-____________________-___________________ - ____________________
Expiration Date (month / year): ______/___ __
Credit Card Verification (CID) #______________
Print cardholder’s name as it appears on card: ____________________________________
Signature: ______________________________
Today’s Date: _______________
Telephone number where we can contact card holder: _________________________________
No invoice reminders will be sent. If payment is not made before date credit card will be automatically charged
on ______________.
A receipt for automatic 2nd payments will be e-mailed to email address on file after processing.