RCRD Skater Dues Form

Rockin' City Roller Derby

Dues Payment Form
Answer a few questions and share your contact information and we'll send you the details.

Orientation: Jan 8th, 9-11am

Dates: Jan 8th - Mar 19th

Location: Round Rock Sports Area, 3918 Gattis School Rd #102, Round Rock, TX 78664

Practice Times: Sundays 9-11am & Thursdays 7pm-9pm. First hour focused on beginners.

Open to all genders; Ages 18+

For derby you need full gear: skates, wrist guards, elbow pads, knee pads, helmet, mouth guard. If you don’t have gear you can borrow ours but plan to get your own mouth guard.

Skaters should be able to stand, stride and stop comfortably without assistance before joining Rec League.

Cost: $140 for 10-weeks
Financial assistance is available! Please contact us before filling out this form about available assistance.
Your Name*
First Last
Email*
This is where league communications will be sent
Derby Name (if applicable)
What do you want coaches to call you? Can be nickname or skate name
Skater Number (1 to 4 digits) (If applicable)
You can update coaches with your chosen number later. You need this to scrimmage.
Do you have any derby experience?*

Yes, more than 1 year of experienceYes, less than 1 year of experienceNo, I'm just getting started
For any experienced skaters, what organizations have you previously skated with?
No abbreviations please, leagues/teams may have similar acronyms
Are you planning to borrow gear?*

YesNoMaybeI'm not sure about "gear", can you provide more info?

Risk of Injury or Illness

Roller skating has the potential for minor or major physical injury. Helmets and safety gear are required to participate in skating activities with RCRD. Participating in skating activities, with or without contact, may increase your risk of contracting or transmitting Covid-19. By completing this form, you knowingly assume all such risks, even those resulting from the negligence of others. RCRD highly recommends participants carry personal health insurance.
Do you understand and agree to abide by the above statements?*

YesNo; I would like to speak to leadership about this before proceeding

Code of Conduct

RCRD acknowledges the need to engage in anti-racist education, and diversity, equity, and inclusion (DEI) efforts in all aspects of our organization. Purposefully homophobic, racist, xenophobic, ableist, fatphobic, transphobic, and other discriminatory behavior; bullying or harassment of any kind will not be tolerated. RCRD understands that sometimes mistakes will be made and, when they happen, we expect individuals to listen and learn from one another, acknowledge their error, and take responsibility to modify their behavior. Repeated Code of Conduct violations will result in disciplinary actions.

Covid-19 Vaccination and Preventative Safety Measures

DEI efforts also extend to community health. We expect everyone who is physically, mentally, and financially able to be fully vaccinated against Covid-19 before participating with RCRD. Those who choose to remain unvaccinated against Covid-19 are not invited to participate with RCRD at this time and/or may be asked to leave. RCRD requests that anyone experiencing symptoms of illness refrain from attending practices and events.
Do you understand and agree to abide by the above statements?*

YesNo; I would like to speak to leadership about this before proceeding
By selecting "yes" below, I certify that I am at least 18 years old. I understand the Code of Conduct and the risks involved regarding injuries and illness. I release Rockin' City Roller Derby and anyone associated from fault or liability.*

YesNo; I would like to speak to leadership about this before proceeding

Payments

Band Member (Rec League)$140.00

Pre-pay for a full session (~10 weeks)

Drop in Fee$10.00

Single practice drop in fee. May not participate in scrimmage days.

Monthly Membership Fee$50.00

Monthly Dues for RCRD Skaters (pre-pay 1 to 6 months)

Quantity

Enter coupon

Total $0.00

Drop-in Date (if applicable)

MonthDay Year
Date
Enter the message as it's shown*
If you need assistance, please email rockincityrollergirls@gmail.com

Need to find a link? Visit our LinkTree

https://linktr.ee/RCRD
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Rockin' City Roller Derby