Club Registration – NORTH IDAHO WATER POLO

Membership Information

You have selected the Juniors - One Player Monthly Membership membership level.

The North Idaho Water Polo Junior Program will have a 3 month session starting Nov. 9th with skills and events set to build over the season. We ask everyone who signs up for the Nov-Jan session to finish the season as we build our skills and want to give our players a chance to work with their teams and our final games at the end of the session. Prior to that (e.g. Sep, Oct), practices are open and we will be working on fundamentals such as swimming, eggbeater kick, passing and basic offense and defense. See the NIWP Calendar for info on dates and practice times. Depending on interest, we may have another season starting in February (Feb-Apr). Parents can add their player (if space is available) prior to and during the first 2 months of the season but not the 3rd month. Late entrant fees will be prorated to the next larger month session (e.g. if you sign up with 1 1/2 months left in the season, the prorated charge will be 2 months or $80). We will be limiting the class size to 30 players so as not to overwhelm the pool space. If you have additional questions, please feel free to email Coach Collingham at northidahowaterpolo@gmail.com

Per Salvation Army/KROC policy, players ages 7-10 must have a parent or other responsible adult on deck during classes.

Note: Your payment will process today, and future monthly payments will occur automatically every month on approximately the same day of the month until canceled.

The price for membership is $40.00 per Month.

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Account Information

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First Name

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Parent Information

Parent 1 Full Name

The full name of the player's parent (e.g. "John Doe")

Parent 2 Full Name

(Optional) The full name of another parent of the player (e.g. "Jane Doe")

Parent Phone Number

A phone number where one parent can be reached.

Acknowledge Photo Policy

We like to share the great things happening with our club, including player achievements and celebrations. Your player's likeness/name may be used on our Website, Social Media, and/or News Media. By checking this box you acknowledge that you understand the above, and that if you wish for your child's likeness/name to not be used you will need to contact Coach Collingham to sign the Photo Exemption Form.

Digital Signature Consent

By checking this option, you consent to using a digital signature for signing the waivers.

Player 1 Information

Player 1 Full Name

The full name of the player (e.g. "Jane Doe").

Player 1 Date of Birth

Used to determine the age of the player only.

Player 1 Email Address

(Optional) An email address for your player.

Player 1 Phone Number

(Optional) A phone number for your player.

Player 1 and Parent agree to the Code of Conduct Waiver

Please read the Code of Conduct Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Travel Waiver

Please read the Travel Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Liability Waiver

Please read the Liability Waiver. Checking the box above acts as your digital signatures.

Player 1 and Parent agree to the Medical Waiver

Please read the Medical Release Waiver. Checking the box above acts as your digital signatures.

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