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Kansas City Roller Warriors Junior Derby Sign-Up
Legal Name of Skater
Skater Name (AKA Derby Name)
Please check here before selecting a name - duplicate names are not allowed.
Please check here before selecting a number - duplicate numbers are not allowed.
Current Skater Skill Level
JRDA level testing is conducted throughout the year - completion of testing is not required to participate
N/A: skater is new to this session
If your skater does not have an e-mail skip this question
Guardian Legal Name(s)
Person(s) who are responsible for the skater.
2nd Guardian Legal Name (if applicable)
2nd Guardian Email (if applicable)
How did you find out about the Junior Warriors Program?
Select all that apply
I'm a returning skater
I have a parent/friend who plays
At a bout
At a Recruitment Event
I'm signing up for the following session
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