Optimus Grime & Rosie Peacock Registration
Optimus Grime & Rosie Peacock on their USA Derby Addict Tour hosted by Woodland Area Roller Derby

August 4th, 12pm-4pm
Estimated Cost (depending on the number of participants) $50-$75

First Name (Real name) *
Your answer
Last Name (Real name) *
Your answer
Derby Name *
Your answer
Date of Birth *
Email Address *
Your answer
Phone Number *
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Skill Level *
Please select from the following: *
League Affiliation *
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