Welcome to the registration page for the Nashville Junior Roller Derby team! 

Please complete the form below to register your skater. 

Skaters can be registered anytime throughout the year. 

Nashville Junior Roller Derby is an amazing community of skaters, coaches, referees, non-skating officals, and parents. Our organization is entirely operated by volunteers who are passionate about mentoring, building community, and junior roller derby! Our motto is that many hands make light work! We ask all families to volunteer at least 15 hours a year. Please indicate your preferred volunteer activity below! Feel free to check more than one!

This portion of the form asks about general health information that is important for us to know about your skater. 

NJRD PHOTO & VIDEO RELEASE AGREEMENT

For consideration which I acknowledge, I irrevocably grant to The Nashville Junior Roller Derby League, licensees, assigns and successors the right to use my image and (skater) name in all forms and media including composite or modified representations for all purposes, including advertising, trade or any commercial purpose throughout the world and in perpetuity. I waive the right to inspect or approve versions of my image used for publication or the written copy that may be used in connection with the images. I relinquish any right that I may have to examine or approve the completed product or products or the advertising copy or printed material that may be used in conjunction therewith or the use to which it may be applied. I release, licensees, assigns and successors from any claims that may arise regarding the use of my image including any claims of defamation, invasion of privacy, or infringement of moral rights, rights of publicity or copyright. Nashville Junior Roller Derby League is permitted, although not obligated, to include my name as a credit in connection with the image. I have read and understood the photo release agreement.

 

I (the undersigned) do hereby confirm the consent heretofore given you with respect to your photographing me or my child in connection with any Nashville Junior Roller Derby video. Additionally I hereby grant to you, your successor, assigns and licensees the perpetual right to use, as you may desire, all motion pictures and sound track recordings which you may make of me or my child, and the right to use my name and/or child’s name or likeness in or in connection with the exhibition or any other use of such video or recording.

WAIVER OF LIABILITY AND ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

 

I, parent or legal guardian, of (Skater’s Name) hereby give authorization for participation in any and all Nashville Junior Roller Derby League activities. I hereby grant permission to managing personnel and league representatives to authorize and obtain medical care from any licensed physician, hospital or medical clinic, should the skater become ill or injured while participating in league activities when neither parent nor legal guardian is present to grant authorization for immediate treatment. I assume all risks and hazards incidental to such participation, including transportation to and from league activities, and do hereby waive, release, indemnify and agree to hold harmless Nashville Junior Roller Derby League and its agents, assigns, representatives, officers and employees from any and all claims arising out of the skater’s participation in any and all league activities.

 

This health history is complete and accurate. I know of no reason(s), other than the information indicated on this form, why my child should not participate in prescribed activities except as noted.  The league, at its discretion, may determine it is a safety risk for your child to participate with the Nashville Junior Roller Derby Association.

 

NASHVILLE JUNIOR ROLLER DERBY INDEMNITY WAIVER

 

I (TOGETHER WITH MY PARENT OR GUARDIAN, IF I AM UNDER THE AGE OF EIGHTEEN OR UNDER A LEGAL DISABILITY) REPRESENT COVENANT AND AGREE, ON BEHALF OF MYSELF AND MY HEIRS, ASSIGNS, AND ANY OTHER PERSON CLAIMING BY, UNDER, OR THROUGH ME, AS FOLLOWS:

 
I ACKNOWLEDGE THAT ROLLER SKATING AND SKATING THE SPORT OF JUNIOR ROLLER DERBY ARE INHERENTLY DANGEROUS ACTIVITIES, BUT STILL DESIRES TO PARTICIPATE IN THESE ACTIVITIES AT HIS OR HER OWN RISK. IF A PARENT OR GUARDIAN OF A MINOR, THE UNDERSIGNED AGREES TO ALLOW THE MINOR NAMED BELOW TO PARTICIPATE IN THESE ACTIVITIES AT HIS OR HER OWN RISK.

 
I AM FURTHER AWARE THAT THE USUAL RISKS, HAZARDS AND DANGERS (HEREINAFTER “RISKS”) OF PERSONAL INJURY, DEATH, DISABILITY, PROPERTY DAMAGE AND OTHER LOSS, NECESSARILY INCREASE WHEN WEARING ROLLER SKATES AND PLAYING JUNIOR ROLLER DERBY. THESE RISKS INCLUDE BUT ARE NOT LIMITED TO, FALLING, JUMPING, LANDING, SKATERS GETTING IN FRONT OF YOU, SKATERS LEANING ON YOU, TRIPPING OVER OTHER FALLEN SKATERS, PERFORMING TRICKS, “SHOW BOATING”, COLLIDING WITH OTHERS, SUCH AS STAFF, MEDIA PERSONNEL AND SPECTATORS. THESE RISKS MAY VARY FROM TIME TO TIME AND DAY TO DAY BASED ON THE SKATERS OWN FATIGUE (TIRED), EQUIPMENT, TYPE OF EVENT, AND OTHER FACTORS. FOR VALUABLE CONSIDERATION, INCLUDING PERMISSION TO SKATE WITH THE JUNIOR DERBY IN ANY WAY, INCLUDING BUT NOT LIMITED TO BEING PERMITTED TO COMPETE, OFFICIATE, OBSERVE, OR PARTICIPATE IN ANY OTHER WAY.

 
I HEREBY RELEASE, WAIVE, DISCHARGE, AND COVENANTS NOT TO SUE THE NASHVILLE JUNIOR ROLLER DERBY LEAGUE, THE NATIONAL JUNIOR ROLLER DERBY ASSOCIATION, THE CLEVELAND STREET RECREATIONAL CENTER, NASHVILLE METRO GOVERNMENT, OR OTHER SKATE VENUES, AGENTS, SUBSIDIARIES, EMPLOYEES, VOLUNTEERS, ANY OTHER PERSON OR ENTITY IN ANY WAY ASSOCIATED WITH THE NASHVILLE JUNIOR ROLLER DERBY LEAGUE, (ALL HEREINAFTER COLLECTIVELY REFERRED TO AS “RELEASEES”), FROM LIABILITY, TO THE UNDERSIGNED, HIS PERSONAL REPRESENTATIVES, ASSIGNS, HEIRS, AND NEXT OF KIN FOR ANY AND ALL LOSS OR DAMAGE, AND ANY CLAIM OR DEMANDS THEREFORE ON ACCOUNT OF INJURY TO THE PERSON OR PROPERTY OR RESULTING IN DEATH OF THE UNDERSIGNED ARISING OUT OF OR RELATED TO USE OF THE SKATE RINK, ITS PREMISES, OR EQUIPMENT, WHETHER CAUSED BY ANY ACT OF NEGLIGENCE OF THE RELEASEES OR OTHERWISE;

I HEREBY ASSUME FULL RESPONSIBILITY FOR ANY RISK OF BODILY INJURY, DEATH OR PROPERTY DAMAGE ARISING OUT OF OR RELATED TO THE USE OF NASHVILLE FAIRGROUNDS SPORTS ARENA, ITS PREMISES, OR EQUIPMENT, WHETHER CAUSED BY ANY ACT OF NEGLIGENCE OF RELEASEES OR OTHERWISE; I HEREBY AGREE TO INDEMNIFY, SAVE AND HOLD HARMLESS THE RELEASEES FROM ANY LOSS, LIABILITY, DAMAGE, OR COST THEY MAY INCUR ARISING OUT OF OR RELATED TO USE OF THE NASHVILLE FAIRGROUNDS SPORT ARENA, ITS PREMISES, OR EQUIPMENT, WHETHER CAUSED BY ANY ACT OF NEGLIGENCE OF THE RELEASEES OR OTHERWISE;

I FURTHER AGREE THAT THIS RELEASE IS INTENDED TO BE AS BROAD AND INCLUSIVE AS POSSIBLE. I UNDERSTAND THAT PARTICIPANTS ARE REQUIRED TO WEAR AN ADEQUATE HELMET, WRIST GUARDS, ELBOW PADS, KNEE PADS, AND A MOUTH GUARD WHILE PARTICIPATING. PARTICIPANTS ARE REQUIRED TO FOLLOW ALL RULES OF CONDUCT AND ARE NOT TO TAKE UNREASONABLE RISKS WHILE USING THE SKATE FACILITY AND PLAYING JUNIOR ROLLER DERBY, INCLUDING CAUSING ANY OTHER SKATERS AN UNREASONABLE RISK OF HARM.

I HEREBY CERTIFY THAT I HAVE PURCHASED JRDA INSURANCE AND IS CURRENT.

I HAVE COMPLETELY READ AND UNDERSTAND THIS WAIVER AND RELEASE AND ITS TERMS.

 
I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND I HAVE SIGNED IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT, ASSURANCE OR GUARANTY BEING MADE TO ME. PRIOR TO SIGNING THIS WAIVER AND RELEASE, I HAVE HAD THE OPPORTUNITY TO ASK ANY QUESTIONS ABOUT THE WAIVER AND RELEASE AND NASHVILLE JUNIOR ROLLER DERBY