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Muhlenberg Water Polo Spring Registration
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* Indicates required question
Email
*
Your email
Child's name (first, last)
*
Your answer
Age as of 4/13/21
*
Your answer
Grade as of 4/13/21
*
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
other
Other:
School Affiliation
*
Muhlenberg
Fleetwood
Exeter
Wyomissing
Reading
Other
Session registering for
*
High School - 3:30 to 4:30 (9th - 12th grade)
Middle School - 4:45 to 5:45 (5th - 8th grade)
Water Polo Experience
*
Never played
1 to 2 years experience
3 years experience
4 years experience
More than 4 years experience
Other:
Medical Information (allergies, asthma, etc.)
*
Your answer
Parent/Guardian Name (first, last)
*
Your answer
Address
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Emergency Contact (Name and phone number)
*
Your answer
Payment method (cash or check....Checks made payable to "Muhlenberg School District Athletic Department")
*
Mail in check or cash (please include Covid waiver form with payment)
Pay the 1st day of practice (please include Covid waiver form on 1st day)
Submit
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