Registration Details Polo Bears 2022/23 Season
Expressions of Interest are requested for the Summer Season to ensure we can plan for our player, coaching, refereeing and team numbers. In addition, we are planning to get an early indication of interest for AYWPC in Perth in January 2023
Player Name
First Name
Last Name
Gender
Male
Female
Date of Birth
-
Day
-
Month
Year
Date
Parent/Carer Name
First Name
Last Name
Parent/Carer Email
example@example.com
Parent/ Carer Phone Number
Please enter a valid phone number.
Player Contact Email (if different)
example@example.com
Player Contact Phone Number
Please enter a valid phone number.
Are you planning to play/trial for another club?
Yes
No
Will Polo Bears be your Primary or Secondary Club?
Primary
Secondary
Which Junior Grades do you wish to play/trial for at Polo Bears in the BWPI 2022/23 Season? (please select all relevant, up to 3 Age Groups):
U12 (Born 2011,12,13,14)
U13 (Born 2010,11,12,13)
U14 (Born 2009,10,11,12)
U15 (Born 2008,09,10,11)
U16 (Born 2007,08,09,10)
U17 (Born 2006,07,08,09)
U18 (Born 2005,06,07,08)
NB: Any Junior Players wishing to play in senior teams please complete box below as well
Which Senior Grades do you wish to play/trial for at Polo Bears in the BWPI 2022/23 Season?
WPQ Premier League (Born 2006 or earlier)
BWPI Senior A Grade
BWPI Social Grade
None
Are you interested in refereeing in the BWPI 2022/23 season?
Yes
No
Are you interested in coaching or assistant coaching in the BWPI 2022/23 Season?
Yes
No
Are you prepared to help the club by taking a role as a Manager/Committee Member or other job? If Yes, please fill in preferred role.
Australian Youth Waterpolo Championships - Perth January 2023. Indicate which team(s) you are interested AND available to play in. Estimated cost $1500-2000. (Max 2 x Age Divisions)
U12 (Born 2011,12,13,14) 15-19 January 2023
U14 (Born 2009,10,11,12) 9 - 13 January 2023
U16 (Born 2007,08,09,10) 15 - 19 January 2023
U18 (Born 2005,06,07,08) 9 - 13 January 2023
Not Available
Comments
Any Additional Information Relevant to your EOI e.g. Playing History Etc
Submit
Should be Empty: