2020 Fall Registration
$300 due by first day of practice on September 29th. If there is a financial need, please let the club know.

PLAYERS WILL NOT BE ALLOWED TO ENTER THE WATER UNTIL ALL FORMS AND FEES ARE TURNED IN.

Make check payable to:

Ashland Water Polo. Mail to: PO Box 623, Ashland, OR 97520. OR submit payment and registration forms to a coach or board member on the first day of practice. You may also pay via PayPal.
Email address *
Athlete's Last Name: *
Athlete's First Name: *
Athlete's Date of Birth: *
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Athlete's Grade: *
Required
Athlete's Phone Number (### - ### - ####): *
Athlete's Home Address: *
Athlete's email Address: *
Parent 1 - First and Last Name: *
Parent 1 - Phone Number: *
Parent 1 - Address: *
Parent 1 - email: *
Parent 2 - First and Last Name (Type N/A if Not Applicable): *
Parent 2 - Phone Number (Type N/A if Not Applicable): *
Parent 2 - Address (Type N/A if Not Applicable): *
Parent 2 - email (Type N/A if Not Applicable): *
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