Registration


Registration for the 2019 Winter Session is now open. Make checks payable to 222 Water Polo and bring to the first practice or mail to:

2420 Pacific Drive #49

Santa Clara, Ca 95051

Athlete Name *
Athlete Name
Athlete Date of Birth *
Athlete Date of Birth
Expiration Date *
Expiration Date
Athlete Cell Phone Number *
Athlete Cell Phone Number
Parent Emergency Contact *
Parent Emergency Contact
Parent Emergency Contact Phone Number *
Parent Emergency Contact Phone Number
Parent or Other Emergency Contact *
Parent or Other Emergency Contact
Parent or Other Emergency Contact Phone Number *
Parent or Other Emergency Contact Phone Number
Athlete Address *
Athlete Address
Please separate each email address with a comma