Monterey Bay Derby Dames Transfer Member Application
This form can be used by skaters, referees, and NSOs who have previous derby experience (former members of MBDD, current or former members of other leagues, etc.). If you have no previous derby experience, please e-mail recruiting@montereybayderbydames.org and request a New Member Application.
First Name *
Your answer
Last Name *
Your answer
Derby Name *
Your answer
Is your derby name registered on two evils? *
If you don't have a derby name, select No.
Date of Birth *
mm/dd/yyyy
Your answer
Contact Information
Address Line 1 *
Your answer
Address Line 2
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
E-mail Address *
Your answer
Phone Number *
xxx-xxx-xxxx
Your answer
Previous League Information
Previous League *
Please spell out the league's full name.
Your answer
Date Joined *
Month and Year (mm/yy)
Your answer
Date Left *
Month and Year (mm/yy)
Your answer
Head Coach Name *
Somebody in a leadership position who can verify your experience (e.g. captains or coaches for skaters, head refs for referees, etc.).
Your answer
Head Coach E-mail or Phone *
Your answer
What was the status of your previous league? *
Indicate its status as of the date you left the league.
What was your status when you left? *
e.g. Fresh Meat, Active Skater, Active Referee, Injured, Leave of Absence, Retired, etc.
Your answer
What was your reason for leaving? *
Your answer
Previous Experience
Have you passed a WFTDA Minimum Skills Assessment? *
Have you skated in a bout before? *
Or officiated in a bout for Refs and NSOs. For this purpose, a "bout" must be full-length according to the ruleset employed and played in front of a paying audience.
Is there anything special we should know?
Coaching/training experience, experience refereeing, leadership position with previous league, non-derby skating experience, MVP awards, etc.
Your answer
Desired MBDD Classifications
My desired Membership Classification is *
If accepted, my desired committee is: *
MBDD members must be active in at least one committee. Indicate at least three (3) choices.
Required
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