2023 Roller Derby National Championships- Officials Application

2023 Roller Derby National Championships- Officials Application

Lincoln, NE July 6-8
Once selected officials will need to be current USARS members in good standing, where in they complete the Safe Sport Athlete protection Training and complete the NCSI Criminal Background check.
Name*

First NameLast Name
Roller Derby Name*
Current Roller Derby Club*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Position (s) Applying For*
Are you a player or a coach also? If yes please list which one.*
Are you available to work the entire Championships? If not please explain below.*
Please upload your Roller Derby Resume

Cancelof
Should be Empty: