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2018 Blue Ridge Water Polo Registration

Parent/Guardian Information

At least one parent/guardian registration is required.
New accounts will be sent an email confirmation message with instructions to setup a password.

At least one parent/guardian email address must be provided.
Check the boxes to indicate which parent/guardians should receive team-wide emails.

First Name * Last Name * Email Address *
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Primary Phone


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Athlete Information

Enter the information for each athlete being registered below. At least one Athlete registration is required.

First Name * Preferred Name Middle Initial Last Name * Gender * Birth Date *
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Home Address

Code of Conduct

As a member of the Seattle Summer Water Polo League, we agree to abide by the League Operating Plan and Code of Conduct by:

  • Consistently display respect, honesty and sportsmanship toward coaches, teammates, officials, volunteers, parents and competitors.
  • Consistently display a positive and supportive attitude toward all teams, coaches, teammates, competitors.
  • Refraining from inappropriate or unacceptable behavior such as:
    • The display or use of aggressive behavior or intentional contact.
    • The use of offensive language, including any derogatory reference to any person’s race, sex, ethnicity or other characteristics.
    • Any activity which would detract from the positive image of the League.

All infractions that result in meet expulsion must be reported to the League board within three (3) days.

Any infraction of this code may result in, but is not limited to, the following actions by the League Board:

  • Restriction from future competition for a designated period of time.
  • Placement on probation for a designated period of time.
  • Restriction from participation in championship competition.
Release and Limitation of Liability

I hereby consent to participation by my child/children listed in this registration on our club team in the Seattle Summer Water Polo League.

The undersigned acknowledges, appreciates, and agrees that there is a risk of injury resulting from my participation in water polo activities, including serious injuries, such as the possibility of my suffering a concussion, broken bone or other injury that could result in permanent paralysis or even death, and that such risk cannot be eliminated. We will assume all risks associated with and incidental to participating on a swim team.

My child/children have no special medical conditions, except those described below, and is fit to participate on a water polo team.

In consideration of the right and privilege for my child to participate, we hereby release, waive, and agree to hold harmless the Seattle Summer Water Polo League, this club, its members, directors, and employees, the club hosting the event, its members, directors, and employees, and coaches, organizers, and parent volunteers for any and all liability, claims, legal actions, and demands of any nature whatsoever which may arise from or in connection with the swim team or related activities. I understand that events may take place away from our club. I understand that the coaches are not responsible for transportation to water polo games or related water polo team activities.

Enter your initials to indicate acceptance: *
Concussion Awareness

A concussion is a brain injury and all brain injuries are serious. They are caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your child reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms may include one or more of the following:

  • Headaches
  • “Pressure in head”
  • Nausea or vomiting
  • Neck pain
  • Balance problems or dizziness
  • Blurred, double, or fuzzy vision
  • Sensitivity to light or noise
  • Feeling sluggish or slowed down
  • Feeling foggy or groggy
  • Drowsiness
  • Change in sleep patterns
  • Amnesia
  • “Don’t feel right”
  • Fatigue or low energy
  • Sadness
  • Nervousness or anxiety
  • Irritability
  • More emotional
  • Confusion
  • Concentration or memory problems (forgetting game plays)
  • Repeating the same question/comment

Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often fail to report symptoms of injuries. Concussions are no different. As a result, education of administrators, coaches, parents and students is the key to student-athlete’s safety.

Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. The “Zackery Lystedt Law” in Washington now requires the consistent and uniform implementation of long and well-established return-to-play concussion guidelines that have been recommended for several years:

  • “a youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time” and
  • “…may not return to play until the athlete is evaluated by a licensed heath care provider trained in the evaluation and management of concussion and received written clearance to return to play from that health care provider”.

You should also inform your child’s coach if you think that your child may have a concussion. Remember it’s better to miss one game than miss the whole season. And when in doubt, the athlete sits out.

For more information about concussions, go to

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Blue Ridge Residents