Last Updated: April 25, 2017

2017 WOMEN'S Masters Annual Registration

* Last Name:
* First Name:
* E-mail address:
* Address:
* City:
* State:
* Postal Code:
* Phone # (000-000-0000):
Birth Date (mm/dd/yyyy):
* Age Group:
* U.S. Water Polo Membership Number. (USWP membership required to practice with CVWP):
Level of Experience:
Suit Size:
Dominant Hand:
Last school you played for.:

Please enter information for any players under age 18
First and last name:
Home Phone:
Work/Cell Phone:
Relationship to minor:

* Emergency Contact - First & Last name:
* Emergency Contact - Home Phone:
* Emergency Contact - Cellular Phone:
* Relationship:

Registration Membership Agreement
Central Valley Water Polo
Consent for Medical Treatment
Waiver & Release of Liability
(To be signed by Parent / Guardian if Participant is under 18)

In consideration of being allowed to participate with Central Valley Water Polo, the undersigned:
Agree that the parent(s) or legal guardian will instruct the minor participant that prior to participating he or she should inspect the facilities and equipment to be used, and if the participant believes anything is unsafe, he or she should immediately advise a coach of such conditions and refuse to participate.
Acknowledge and fully understand that each participant will be engaging in activities that involve risk or serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction, or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time.
Assume all foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death.
Release, waive, discharge and covenant not to sue United States Water Polo, Inc., its affiliated Clubs, including Central Valley Water Polo Club, Sunnyside High School, Fresno Unified School District, and if applicable, owners and lessors of premises used to conduct the program and / or events, all of which are hereinafter referred to as “releases,” from any and all liability to each of the undersigned, his or her heirs and next of kin for any claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in the whole or in part by the negligence of the releasees or otherwise.
Agree to allow their names, photographs, and non-sensitive personal information (e.g. game statistics, home town) to be used in Central Valley Water Polo communications, including but not limited to news releases, emails, flyers, brochures, TV newscasts, and on the club website. Personal information collected by the club as part of membership information will not be shared with third parties.
I/WE have the above waiver and release, understand that I/WE give up substantial rights by signing it and sign it voluntarily.
If athlete is less than 18 years of age, then the parent or legal guardian must also sign. This is to certify that, as parent/guardian of this participant, I do consent to his/her waiver and release as set forth above. I hereby consent to the administration of emergency medical care to the participant as prescribed by a duly – licensed doctor of medicine or doctor of dentistry. This care may be given as necessary to preserve life, limb and well being of the participant.
Central Valley Water Polo
Code of Conduct
Members of Central Valley Water Polo are expected to behave reasonably at all times while participating in activities or otherwise representing the club in general. Expected behavior includes respect, self-control, cooperation and good sportsmanship towards other participants, spectators, and officials.

Central Valley Water Polo will use the following guidelines to consider whether a member of the club or non-member participating with the club has acted consistently with expected conduct. A player’s expectations are as follows:
USA Water Polo membership current and in good standing.
Central Valley Water Polo membership dues or tournament sign-up fees are current.
Demonstrate sportsmanship during tournaments, organized games, and training.
Participate in building or breaking down any practice facilities including cages, lane lines, pool covers, caps, balls, etc.
Profanity will NOT be tolerated.
Verbal abuse of officials, referees, bystanders, or other players is unacceptable.
For members under the legal drinking age, there is Zero Tolerance for the use of alcohol. CVWP exercises a Zero Tolerance policy in regards to illegal drugs.
Possession of or being under the influence of alcohol or illegal drugs will not be tolerated on any Fresno Unified School District facility.
If a CVWP member intends to participate in a National Championship Tournament (i.e. Junior Olympics, Masters Nationals), it will be for Central Valley Water Polo, unless otherwise permitted by the CVWP Board.
If a member or participant with CVWP is considered to be outside the parameters set forth within the Code of Conduct standards, the President of the club will exercise full authority in dealing with the violating participant. If the behavior continues, the situation will be presented to the Executive Committee by respective representatives, or any other Board member, for immediate review. A member in violation of the Code of Conduct can and will have his/her membership terminated with unanimous vote by the Executive Committee. Should this occur, any fees paid will be considered forfeited and will not be reimbursed. Central Valley Water Polo reserves the right to refuse service to any person so long as they do not fall into one of the protected classes of people covered under federal anti-discrimination laws.

I have read and fully understand the above requirements of participation with Central Valley Water Polo. Filling in any initials in the following field to complete this registration constitutes "signing" and agreeing to the above Consent for Medical Treatment, Waiver & Release of Liability, and Code of Conduct for Central Valley Water Polo for you if you are over 18, or for your child if you are a parent registering your child.
* * I have read the information above and agree to the terms. Please type initials:

* required

Select Fee

Regular Membership($105)
Full time college student rate (12+ units)($55)
Donation to CVWP - Bronze Level($20)
Donation to CVWP - Silver Level($50)
Donation to CVWP - Gold Level($100)

Payments Accepted By

Note: Credit Card information can be entered once this form is submitted