Water Polo Registration Form 2025 "*" indicates required fields Child InformationChild's Name* First Last Child's Age*As of June 14thHas your child ever played water polo before?*YesNoWhich class level are you registering for?*Beginner (7-8pm)Intermediate (8-9pm)Parent InformationThis field is hidden when viewing the formMember #0Name* First Last Email* Phone*Emergency InformationEmergency Contact* First Last Phone*In case of emergency, Preferred HospitalPayment InformationAre you an OHAC member?*YesNoWater Polo Class* Price: Total Due Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Order Token