Broncos Winter Session Aquatics
Winter Session Type *
PayPal Confirmation Number *
Please make your PayPal payment PRIOR to completing this form. In the blank below, please insert your PayPal confirmation number given to you as a receipt.
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USA Water Polo Number
For Water Polo Players: To attend Winter Water Polo tournaments in the Winter or Summer, an athlete must have a Silver or Gold USA Water Polo Membership. The Memberships renews on January 1 of each year. Please apply or renew memberships at USA Water Polo.
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Athlete's Name *
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Athlete's Grade *
Athlete's Age *
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Athlete's Phone Number
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Parent's Name *
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Contact Phone Number *
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Contact Email *
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Emergency Contact Name *
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Emergency Contact Phone Number *
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Name of Guardian Authorizing Form *
*My son/daughter has permission to participate in the Winter Water Polo Camp. Should it be necessary for my child to have medical treatment while participating at the camp, and if the camp is unable to contact me, I hereby authorize Clovis Unified School District personnel to use their judgment in obtaining medical services for my son. I also understand that there is an injury risk with participation in sports and release Clovis Unified School District of any liability. Also, in accordance with CIF bylaw 207, any athlete who transfers from School “A” to School “B” after having prior contact, during the previous 24 months, either directly or indirectly with school “B” prior to enrollment shall not be eligible at School “B” for 365 days from initial date of enrollment. This includes this camp, clinic, AAU, club team, and/or workouts.
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