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2017 Bearcat Summer Water Polo
*
Last name:
*
First name (legal name):
Preferred name or nickname:
*
Gender:
Female
Male
*
Group:
Boys High School
Girls High School
Middle School
*
T-Shirt Size; Ladies or Adult (x-small - xx-large):
Ladies x-small
Ladies small
Ladies medium
Ladies large
Ladies x-large
Ladies xx-large
Adult x-small
Adult small
Adult medium
Adult large
Adult x-large
Adult xx-large
*
Grade for Upcoming School Year:
6th
7th
8th
9th
10th
11th
12th
*
Birth date:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
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16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Your personal phone number:
*
Your personal email:
*
Parent (guardian) first and last name:
Additional parent (guardian) first and last name:
*
Parent (guardian) phone number:
Additional phone number:
*
Parent (guardian) email:
Additional email:
USA Water Polo ID Number:
Age of 8/1/17:
* indicates required fields
