VCJRD New Member Interest Form
We can be reached by email at Coaches@vettecityjuniors.org.  You can also message our Facebook, or Instagram with questions and checkout and subscribe to our VCJRD YouTube Channel.

We will be taking new skaters starting in February of 2026.  Fill out the interest form and you will get an email once we have confirmed dates. 

While we do not have a minimum age, your child will need to be able to pay attention and follow instructions in a group setting for 1.5 hours to be ready to participate in our juniors program.

Sign in to Google to save your progress. Learn more
Email *
Child's First Name *
Child's Last Name *
Child's Preferred name or Derby name
Parent's First Name *
Parent's Last Name *
Are you new to Junior Roller Derby or a Transfer Skater?
Clear selection
Current age
Date of Birth *
MM
/
DD
/
YYYY
Pronouns
Which Skating experience best describes you?
Clear selection
Do you currently own quad roller skates to use for new skater training? 
Captionless Image
Clear selection
Sizing Question (Answer if you will need to borrow loaner skates.)  What is your typical size in Vans lace up shoes?  Vans sizing runs most consistent and closest to skate sizing.
Clear selection
Do you have the following protective gear?                (We do have limited loaner gear that might be available if needed.)
Captionless Image
How did you hear about joining us?  If a skater recruited you please tell us their name or where you were when they recruited you.
Anything additional you would like to let us know?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Vette City Roller Derby.

Does this form look suspicious? Report

Google Forms