Join Water Polo Club
Login Club Members
Please Login above to your Rutgers account before filling the form below
Primary Phone: ()
Number of Years Affiliated with this club:
Campus Address: City: , Zip:
Home Address: City: , Zip:
Do you have any known Allergies?
Do you take any Medications?
Do you have any Special Health Needs?
Please check the box if you are currently CPR or/and First Aid certified: