RHINOS Summer 2019 Pool Session Application
This is for Thursdays, 7:30-9pm from May 30 -July 18.

Please submit this form along with your donation (paypal to bayareakayakpolo@gmail.com or check to "Bay Area Kayak Polo"). Thank you and see you on the water!

Athlete Name *
Current Grade (6th - 12th) *
Parent/Guardian Name *
Parent Cell Phone Number *
Can we add this phone number to a group text message service called Remind? *
Parent Email
Donation: We are a volunteer-run organization. Would you consider donating to help us pay our youth coaches, cover insurance fees, and buy new equipment? ($50 recommended, but any amount is appreciated!) *
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) *
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