East London BIWPA Boys u16/u19 Camp Registration Jan 2025

Player First Name *

Player Last Name *

Select Gender *

Parent-Guardian - Name *

Parent-Guardian - Last Name *

Parent Mobile number *

Parent Email *

Player Questions

Date of birth *

Left Handed or Right Handed *

Left hander

Right Hander

What position do you play *

Goalie

Center Back

Center forward

Link/Wing

Which team do you currently play for? *

AFTER YOU HAVE CLICKED SUBMIT BELOW, PLEASE WAIT FOR THE PAYMENT PAGE TO SECURE YOUR SPOT AT THE CAMP.

By ticking this box, I agree to Elevate Water Polo's attached Terms & Conditions. https://policies.elevatewaterpolo.co.za/terms-conditions