2024 Intro to Derby Registration Form
Register for Royal City Roller Derby's Winter 2024 Intro to Derby Session
For detailed information: https://docs.google.com/document/d/18mSmuINGQqI0tqW-cZ5lzWiIDTg7oTqE6WiFTFK4RPE/edit?usp=sharing 

Saturday Mornings 9-11am @ Westwood Public School in Guelph
Dates:
Jan 13
Jan 20
Jan 27
Feb 3
Feb 24
March 2
March 9
March 19
March 23
April 6

This form will take 5-15 minutes to complete.

Section 1: Basic Info
Section 2: Primary Emergency Contact Info
Section 3: Secondary Emergency Contact Info
Section 4: Emergency Health Information
Section 5: Media Release Form


Sign in to Google to save your progress. Learn more
Email *
Where did you hear about RCRD intro to derby?
Preferred First Name *
Last Name *
Pronouns *
e.g. She/Her, They/Them 
Date of Birth *
MM
/
DD
/
YYYY
Phone Number *
Email Address *
This is our primary method of communication, please ensure it is accurate.
Primary Focus for Intro to Derby *
Check any that apply (this just helps us structure the program better)
Required
Roller Derby or Skating Experience 
Optional: Check any that apply (this just helps us structure the program better)
I acknowledge that my spot in the RCRD intro program  is confirmed only once payment of $100 is made to  treasurer@royalcityrollerderby.com
OR once I have contacted treasurer@royalcityrollerderby.com and agreed on an alternate payment plan.
 *
I acknowledge that I MUST purchase roller derby insurance before the first session or I won't be able to participate on-skates. *
To get insurance, go to  https://www.wftdicanada.ca/cpages/membership  and select skater membership
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Royal City Roller Derby. Report Abuse
Google Forms