Clubs Sports

Join Womens Soccer Club

Membership Form

*Incomplete Form

Officer Position:

First Name:

Last Name:

Birth Date:

CalPoly Email: @calpoly.edu

Primary Phone:

Local Address: City: Zip:

Year in School: First Second Third Fourth Fifth Grad Other

Parent/Guardian Name:

Parent/Guardian Email:

*Permanent Address: City: Zip:

*International students- enter both your city and country in 'City' field, select 'Int' for State

Permanent Home Phone Number:

Are you currently CPR and/or First-Aid certified? CPR First-Aid

(Password to Login later to your account- please don't use your Cal Poly password)

Create Password:

Confirm Password:

If your submission is successful, Confirmation Email would be sent to your email address-
please click on a link there and active your Club Sports account.
Once your account is activated, you would be able to Login at the top of the page and use previously submitted details.
You will also proceed to Medical Insurance form.