2025 USARS Roller Derby National Championships Team Entry Form

2025 ROLLER DERBY NATIONAL CHAMPIONSHIPS- INTENT TO PARTICIPATE APPLICATION/ TEAM REGISTRATION APPLICATION
Non Refundable Deposit - intent to play due April 25

Final Team Payments are due June 6

Final Rosters and individual skater membership registration will be due by July 9

Fees can be refundable in the event Nationals is cancelled or your team does not make it into the tournament.

Teams can get $50 off the full registration if bringing 1 or more qualified and approved officials. Official cannot be a skater/official crossover for this discount.

League officials may apply at headofofficials@gmail.com

All clubs/teams, coaches and skaters must be a current USARS member in good standing
Club/Team Name*
Club/Team Colors*
Club/team Captain *
USARS Club ID Number*
Club/Team Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Desired Competitive Division*

Open GenderFemaleMale
Primary Contact
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Club/ Team Website and/or Social Media Pages
Payment Information

My Products

Intent to Participate- Non Refundable

$100.00

Remaining Fee After Intent to Participate

$300.00

Remaining Fee After Intent to Participate- With Official Discount

$250.00 Quantity

Total

$0.00

2025 ROLLER DERBY NATIONAL CHAMPIONSHIPS- INTENT TO PARTICIPATE APPLICATION/ TEAM REGISTRATION APPLICATION