2019 - 2020 Back Bay Water Polo Registration
Registration for participation in the Back Bay Aquatics Foundation water polo program.
Your registration is for seasonal participation, unless paying for a full year which is indicated below. After your initial registration, you will be automatically invoiced every season for ongoing participation. The season will run in accordance to the dates posted on our website. Please visit www.backbaywaterpolo.com for seasonal information.
Email address *
Are you a new or returning member *
Required
Participant's First Name *
Your answer
Participant's Last Name *
Your answer
USA Water Polo #
Your answer
Participants age group *
Participant's Birthday *
MM
/
DD
/
YYYY
Participant's Grade *
Your answer
Guardian's Full Name *
Your answer
Guardian's Home Street Address *
Your answer
Guardian's Home City, State, Zip *
Your answer
Guardian's Phone Number *
Your answer
Guardian's Email
Your answer
If there is a secondary guardians name who you also want to receive email information, please include below. (Optional)
Secondary Guardians Full Name (Optional)
Your answer
Secondary Guardian's Phone Number (Optional)
Your answer
Secondary Guardian's Email (Optional)
Your answer
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