5/21/22 BGR “Action on Wheels” Skate Hang
Registration form for BIPOC youth to skate with Brown Girl Rise and Rose City Rollers

Join BrownGir|Rise for our first
MONTHLY Action on Wheels! AGES 7-17! There will be a
special action project created by our youth, food,
and equipment provided! A special thank you to
Rose City Rollers for proving us the space and
equipment to make this possible!

Ven a la primera accion sobre ruedas mensual de
Brown Girl Rise! Habra un proyecto especial
creado por nuestra juventud, comida y equipo
proporcionado. Un agradecimiento especial a
Rose City Rollers por brindarnos el espacio y el
equipo para hacer esto posible!



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Have you signed a waiver? Please copy and paste this address into your browser to sign. All participants are required to sign this waiver before attending the event. Please copy and paste this link into your browser to sign: https://waiver.smartwaiver.com/w/5eb07182c17b2/web/ *
Name *
Participant Name? *
Participant Age? *
Pronouns:
Do you identify as Black, Brown, Indigenous, or a Person of Color?: *
Shoe size? for FREE skate rental
Parent or Guardian Name: *
Parent or Guardian Number: *
Parent or Guardian Email:
Please list any dietary restrictions, allergies, physical, medical or emotional needs so we can best take care of you! *
Anything else we should know about ya?
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