Date of Birth*

Gender*

Parent/Guardians Name*

Parent/Guardians Email*

Which school do you currently attend?*

Will you be competing with another school or club in the 2025/26 Summer Season?*

Which junior divisions do you wish to trial for Vikings in the BWPI 2025/26 Season? (Please list age groups you wish to nominate for?*

Will Vikings be your Primary or Secondary Club?*

Are you interested in refereeing in the BWPI 2025/26 season (Players Born 2012 and older)*

Are you interested in coaching in the BWPI 2025/26 season? (Players Born 2008 and older)*

Are you interested in competing at the Australian Youth Water Polo Championships in April, 2026? Please indicate your interested age groups. This is not a formal nomination and is intended to assist in clubs planning for the event.

Are you interested in competing at the WPQ State Titles in January, 2026? Please indicate your interested age groups. This is not a formal nomination and is intended to assist in clubs planning for the event.

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