East Bay RHINOS Fall 2019 Application
Girls Team: September 5, 12, and 19 from 7:30-9:00pm
Boys Team: October 10, 17, and 24 from 7:30-9:00pm
Mini Tournament (tentative): Saturday November 2nd 3-6pm (group dinner afterwards at Los Pericos)

Please submit this form along with your donation (paypal to bayareakayakpolo@gmail.com or check to "Bay Area Kayak Polo"). For scholarships, fill out the application here:

Thank you and see you on the water!
Email address *
Student name *
Grade *
Which season? (girls can choose both)
Parent Name *
Cell Phone # *
Can we add this phone number to a group text message service called Remind? *
Parent Email
Fees: Please select which option best suits your needs and send via paypal to bayareakayakpolo@gmail.com, or bring cash/check to first session *
Previous kayak, watersports or athletic experience *
Any medical conditions (allergies, medications, previous injuries, etc.)? *
Permission for Bay Area Kayak Polo to use photos/video of participant for outreach? *
Parent/guardian: By typing parent name below, parent gives consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent. (please type FULL parent/guardian name) *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.