Santa Monica Water Polo and Splashball Form

IMPORTANT!! USA WATER POLO REGISTRATION & AGE VERIFICATION

IF PLAYER IS NOT CURRENTLY REGISTERED WITH USA WATER POLO, PLEASE RENEW OR REGISTER NOW!!

In addition to completing the registration form below, all SMWPC athletes must register with USA Water Polo as a member of Santa Monica Water Polo Club in order to practice or compete. Memberships are on a calendar year basis, and expire on December 31. New registrations or renewals made between November 1 and December 31 will be valid for the following calendar year. Registration must be completed online via the USA Water Polo website at www.usawaterpolo.org using a VISA or MasterCard.

AGE VERIFICATION

Once the USA Water Polo registration is completed, the age verification needs to be completed. Instructions are on the USA Water Polo website, at www.usawaterpolo.org

How did you find out about us?*

Athlete's Name:*

First NameLast Name

Address:*

Street Address

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Athlete's Cell Phone:

Area CodePhone Number

Athlete's Email:

Birth Date*

MonthDayYear

Age:*

Parent/Guardian #1: (Athlete's info if Athlete is over 18 years old)*

First NameLast Name

Parent Cell Phone: (Athlete's info if Athlete is over 18 years old)*

Area CodePhone Number

Parent Home Phone: (Athlete's info if Athlete is over 18 years old)*

Area CodePhone Number

Parent E-mail: (Athlete's info if Athlete is over 18 years old)*

Parent/Guardian #2:

First NameLast Name

Parent Cell Phone:

Area CodePhone Number

Parent Home Phone:

Area CodePhone Number

Parent E-mail:

USA Water Polo #:*

Go to www.USAWaterPolo.com to register if you dont have a USAWaterPolo membership number, see instructions below:

1. Join USA Water Polo (Insurance requirement for practice facilities/tournaments): Click here for USA Waterpolo Membership

2. Click on the “Join USA Water Polo” button

3. Select “Gold Athlete” for membership type

Very important!! Your club is – Santa Monica Water Polo Club, Club ID 19155

USA Water Polo Membership Expiration Date:*

MonthDayYear

PARTICIPATION AND RELEASE

PARTICIPATION AND RELEASE AGREEMENT: I/we or the undersigned parent(s) or legal guardian(s) of the player named above ("Player"), for ourselves and on behalf of Player, our heirs, assigns, and agents, acknowledge that participation or receipt of instruction in splashball & water polo necessarily involves travel, play in adverse weather conditions, physical contact and risk of severe and permanent physical injury. On behalf of myself/ourselves, Player, our heirs, assigns, and agents, I/we willingly and voluntarily accept and assume all such risk. In consideration of accepting the registration and permitting Player to voluntarily participate in the splashball & water polo program operated by Santa Monica Water Polo Club ("SMWPC"), for myself/ourselves, and on behalf of Player, our heirs, assigns, and agents, I/we hereby release, discharge and agree to hold harmless SMWPC, its employees, volunteers, officials, sponsors, officers, directors, owners, and other representatives from any and all claims (including, but not limited to personal injury, property damage and wrongful death claims), demands, costs, expenses and compensation arising out of or in any way related to any physical injury or other damages that may result from Player participating and/or receiving instruction in any water polo event sponsored and/or operated by SMWPC, including any physical or other injury caused by the willful or gross negligence of any person while performing his/her duties at any time. I/we understand and agree that this Release will have the effect of releasing, discharging, waiving and forever relinquishing any and all actions or causes of action that I/we or Player may have or have had, whether past, present, or future, whether known or unknown, and whether anticipated or unanticipated by me, arising out of Player’s participation or receipt of instruction in splashball & water polo. This Release constitutes a complete release, discharge and waiver of any and all actions or causes of action against SMWPC. For myself/ourselves and on behalf of the Player, I/we further acknowledge that SMWPC is primarily administered by volunteers and not paid professionals. For myself/ourselves and on behalf of Player, I/we voluntarily agree to comply with the stated and customary terms and conditions for participation and, if I/we have any unusual or significant concerns about Player’s readiness for participation or in the program itself, I/we will withdraw Player from participation and immediately bring any such concern(s) to the attention of the nearest SMWPC coach or official.

Media Authorization:

AUTHORIZATION/CONSENT TO PUBLISH A PHOTO, VIDEO, MOVIE, QUOTES: I/We or the parent(s) or legal guardian(s) of Player, hereby authorize Santa Monica Water Polo Club (SMWPC), as agent(s) to publish photographs, videos, movies, quotes, of Player for the express purpose of athlete recognition and club promotion. I also grant SMWPC the right to edit, use and reuse said products for use in print, internet, and all other forms of media. I/we also hereby release SMWPC and its agents, employees and volunteers from all claims demands and liabilities whatsoever in connection with the above.  ACKNOWLEDGMENT & CONSENT: I/we acknowledge that we have read this Release Agreement and that I/we understand the terms, and understand that I/we and Player have given up substantial rights by our signing this Release Agreement and agreeing to these terms, and we sign this Release Agreement and agree to these terms freely and voluntarily and without inducement for ourselves and on behalf of the Player. By submitting this form, I/we consent to and agree to abide by the terms of the foregoing “Release from Liability”, and the “Medical Treatment Authorization For Minor”, “Player Code of Conduct”, and “Parent Code of Conduct” below

Code of Conduct:

PERFORMANCE STANDARDS AND CODE OF CONDUCT.  1. Statement of Purpose: SMWPC offers a competitive water polo program for male and female athletes. The object of the program is to develop and hone athletic skills and techniques through safe, instructive, and appropriately challenging workouts and competitive opportunities. An equally important goal is to teach life skills and values such as discipline, good character, setting and striving to achieve goals, good sportsmanship, and mental strength, while developing a love of sports and camaraderie with teammates, and to build self-esteem and self-discipline in each participant. The program seeks to inspire each participant to be a scholar-athlete, by encouraging each participant to strive to achieve the highest level of academic standards and athletic performance of which he or she is capable. The program expects to accomplish its goals in a manner which promotes mutual respect, civility, and orderly conduct among the participants, coaches, fellow athletes, and members of the broader community. Finally, through instruction, modeling, and encouragement, parents play a large role in ensuring that the program achieves its goals and develops young men and women of character.  2. Performance Standards: In order to be successful in SMWPC programs, each participant must meet the following performance standards: 1. Attend all scheduled practices. 2. Arrive at each scheduled practice, competition, and program at the time designated by the Head Coach or Assistant Coaches, appropriately dressed in team gear ready to begin practice, the competition, or program on time. 3. Work diligently during practice to maximize performance and improve skills and techniques. 4. Follow instructions given by the Head Coach and Assistant Coaches; cooperate with coaches & teammates to achieve common goals. 5. Avoid engaging in any disruptive or disrespectful behavior before, during, or after practices, or while traveling to or from, or attending competitions. 6. Schedule appointments and outside activities around practices & games. 7. Be mentally & physically prepared for practices & games; strive to achieve the best result/performance of which each participant is capable at each competition, employing the skills, techniques, and strategies learned during practices. 8. Strive to maximize academic performance (manage time wisely & efficiently; seek help if & as needed). 9. Be accountable for actions; accept responsibility for actions & choices. 10. Read, become, and be informed of all communications relating to the program. 11. Direct all questions regarding practices, games, and the like to the coaches. 12. Participants, not their parents, are to be the primary contact for all questions or communications regarding playing time and lineups, unless the Head Coach or Assistant Coaches specifically request or instruct otherwise.  B. Code of Conduct: 1. Always engage in conduct which befits a member of the SMWPC programs, and as a role model for peers and other athletes. 2. Comply at all times and in all respects with the with the USA Water Polo, Inc. Rules Governing Athletes’ Conduct (incorporated by this reference). 3. Behave in a civil manner at all times, which includes, among other things, no hazing, obscene, profane, or vulgar behavior, gestures, or language, taunting, jeering, or inciting others. 4. Resolve any disputes only through conversation and compromise at all times; refer any unresolved matters to the coaches. 5. At all times, behave cooperatively and respectfully toward, and be positive, encouraging, and supportive of the Head Coach, Assistant Coaches, teammates, other students, faculty, officials, visiting or other players, students, and coaches. 6. Practice and observe safety rules and procedures at all times. 7. Respect the facilities and personal property belonging to others at all times; restitution will be required for any damage (Note: parents are responsible for restitution or repair of any damage caused by their children, regardless of age). 8. Be responsible for personal gear at all times. 9. Keep facilities clean and orderly at all times; help others when and as requested. 10. Practice self-respect & exhibit pride in self, work, accomplishments & team at all times. 11. Be honest, trustworthy (to self, coaches, & teammates), & loyal (to teammates & program) at all times.   C. Consequences: Failure to abide by the Performance Standards or Code of Conduct will result in disciplinary action against the offending participant(s). Disciplinary measures will be determined by the Head Coach, as deemed by the Head Coach to be appropriate in relation to the infraction. Disciplinary measures may include any or all of the following: 1. Extra swimming, running, or training. 2. Exclusion from one or more practices or competitions. 3. Temporary suspension from the program. 4. Expulsion from the program. By agreeing below, Player acknowledges that he or she has read and agrees to satisfy the Performance Standards and abide by the Code of Conduct of the SMWPC. If he or she fails to do so, Player understands and agrees to accept the Consequences imposed by the Head Coach. By agreeing  below, I/we or parent(s) or guardian(s) of Player, acknowledge and approve the foregoing Performance Standards and the Code of Conduct of the SMWPC programs. I/we will support the expectations, goals, and philosophy of the Statement of Purpose, and abide by the Performance Standards and Code of Conduct of the SMWPC programs, including any Consequences imposed by the Head Coach. I/we have also received, read, and hereby approve and agree to abide by the SMWPC Parent Code of Conduct below which is incorporated here by this reference, and in doing so, I/we will use my/our best efforts to be a positive, supportive spectator and fan at games, refrain from coaching or yelling at the coaches, referees and scorer’s table from the stands. I/we understand that if I/we fail to do so, I/we may (i) be asked to leave the pool area or event venue for the remainder of the game or event, (2) not be allowed to attend future games, and/or (iii) Player and/or I/we may be excluded from further participation in SMWPC programs, as the Head Coach and/or Board of Directors of SMWPC may determine.

Parent Code of Conduct:

PARENTS’ CODE OF CONDUCT:  Santa Monica Water Polo Club (SMWPC) strives to win and to build the character of its players to help them develop into successful contributing members of society. Parents are very important partners in this process; the SMWPC coaches and parents work together to ensure that through participation in sports, their children learn lessons that will help them succeed in life. Parents must let coaches and athletes worry about the scoreboard while encouraging their players to master life. To help parents succeed as partners, SMWPC has endorsed the following Parents’ Code of Conduct, which applies to parents of all players in all age groups (youth through post-high school): 1. Parents may watch practices and are encouraged to attend games. But unless they are assisting with administrative tasks related to the operation of SMWPC or the production of events, parents must stay off the immediate pool deck and away from coaches during practices and games. 2. Parents are expected support the players, coaches, and other parents with positive communication and actions and avoid idle gossip. At games, Targeted Cheering and No-Directions Cheering from the deck, such as “Great Effort!”, “Nice teamwork!”, “Get ‘em next time!”, and “Way to Go!” are appropriate. 3. Parents should praise their children for their efforts and learning. Parents should never chastise their children, teammates, or opponents in public. Parents should explain that mistakes are made in sports and can be learned from. Parents fill their players’ emotional tanks. Parents provide truthful and specific praise, express appreciation, listen, and are attentive to their own nonverbal cues with their children. Criticism, sarcasm, ignoring, and nonverbal negative cures are not appropriate. 4. Parents Honor the Game by respecting the Rules, considering opponents to be worthy, respecting officials, encouraging teammates, and respecting themselves and their players. 5. Parents are role models who resolve conflicts without resorting to hostility or violence. Parents seize upon teachable moments, build the culture of SMWPC, and develop and practice self-control routines to ensure calm on the sidelines. 6. Parents and their Guests maintain self-control and Honor the Game by refraining from making disparaging remarks about or directed SMWPC’s players, coaches, opponents, other parents, or officials. Parents do not participate in, engage in, promote, or condone physical and/or verbal confrontations. 7. Parents do not participate in, engage in, promote, or condone behaviors that endanger the health, safety or well-being of any coach, parent, player, participant, official or any other attendee. 8. Parents recognize they are not coaches. They recognize that players receive water polo instruction from the coaching staff, not from parents. Parents understand that their role is parent- not coach, official or player. Parents respect the coaches and refrain from coaching their children or other players during competitions and practices because it may conflict with the SMWPC. coaches’ plans or strategies. Parents have a very important role to play: ensuring their children take away from sports lessons that will help them be successful in life. 9. Parents understand that SMWPC’s second goal, besides winning, is to help water polo players learn the life lessons of youth sports. Players (not the parents) are responsible to communicate directly with coaches when issues arise. Players’ communications directly with coaches is critically important for parents to encourage and players to do as they mature into high school and beyond. Parent-player appointments can be made with coaches in advance. Head coaches of each program are available to discuss program issues with parents by schedule in advance. 10. Parents understand that decisions about playing time, travel teams, and all other water polo related matters are made exclusively by the coaching staff and are not open to debate, discussion, or negotiation with parents. A player should feel free to discuss his/her status with the coaches at an appropriate time. Playing time and travel teams are not distributed on an equal basis and are not guaranteed by club membership. 11. Parents promote the emotional and physical well-being of athletes ahead of any personal desire Parents may have for their child to win. 12. Parents inform coaches of any physical disability or ailment that may affect the safety of their children or the safety of others. 13. Parents arrange transportation for their children to and from SMWPC events unless an “away event” dictates otherwise. SMWPC is grateful for parents who help others arrange transportation and carpool. 14. Parents ensure punctuality of their children at practices and at meets. If a player cannot be on time, be early! 15. Parents recognize that no player is allowed to participate in any practice or game unless he/she is currently registered as a member in good standing with USA Water Polo, Inc. (USAWP) and SMWPC. Except for newcomers and exceptions made by SMWPC 's Board of Directors, all club dues must be paid in full in order for a player to be allowed to participate in any SMWPC events. Parents recognize their players are subject to the USA Water Polo Code of Conduct. 16. Parents understand that SMWPC is a community that extends beyond their own children’s narrow involvement. 17. Parents use their best efforts to share the burden among parents by volunteering in the areas of pool set-up, event planning, travel team logistics or other areas. SMWPC is grateful for parents who build up our community. Parents appreciate and recognize the importance of volunteers and SMWPC officials. 18. Parents understand that direct contributions to the club for specific purposes such as hats, sports equipment, scholarships, and defraying travel costs will be gratefully accepted and recognized. 19. Parents understand that children who may not be able to participate in SMWPC or SMWPC events for personal financial reasons may contact a coach or administrator discreetly to request financial assistance. All financial assistance matters are decided by the Board of Directors. SMWPC does not intend to deny participation for true financial need. 20. Parents assist everyone at SMWPC in providing a sports environment for their children that is free from drugs, tobacco, and alcohol. Parents do not attend any SMWPC competitions or practices while under the influence of drugs or alcohol.

Athlete's AcknowledgementParent's or Legal Guardian's Acknowledgement (Athlete's Acknowledgement if Athlete is over 18 years old)

I agree

Monthly Membership Dues:*

Splashball and Elementary School Water Polo ($135 for the first month, then $135 each month thereafter)($135.00 for each month)

Middle School Water Polo ($230 for the first month, then $230 each month thereafter)($230.00 for each month)

Master's Water Polo ($75 for the first month, then $75 each month thereafter)($75.00 for each month)

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