Monochromatic Mania Bout 2017 Registration
Legal Name *
Your answer
Skater Name *
Your answer
Skater Number *
Your answer
Which league are you with? *
Your answer
WFTDA or USARS Number *
Valid/Current Roller Derby Insurance is MANDATORY
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Emergency contact *
(Name and Phone Number)
Your answer
What is your skill level? *
Fresh Meat bout clearance letters from your home league should be emailed to
Which positions do you play? *
Tank Top Size *
(If registered before November 18)
Your answer
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