Nashville Roller Derby 2020 Scrimmage-A-Thon
Please enter the form below if you want to officiate at the Scrimmage-A-Thon on July 11th, 2020, hosted by Nashville Roller Derby. You should be able to be at the venue from 8-4 and will be considered for the doubleheader that night. More information will be provided shortly after application.

This form is for both skating referees and non-skating officials. Very few of the questions are required, so if a question doesn't apply to you, feel free to skip it.

Please note: Application doesn't guarantee position.
Derby Name *
Legal Name
League Affiliation
Email address *
Phone Number
2020 Roller Derby Insurance Provider and Number?
I am applying to: *
Applying to referee or NSO will allow you to be considered as a referee for some scrimmages, but you would primarily be considered for NSO roles.
Referee Certification level
Rate your skating skills
Poor
Exceptional
Clear selection
Rate your ability to Head Referee
No experience
WFTDA Championships level
Clear selection
Rate your ability to Jammer Referee
No experience
WFTDA Championships level
Clear selection
Rate your ability to Inside Pack Referee
No experience
WFTDA Championships level
Clear selection
Rate your ability to Outside Pack Referee
No experience
WFTDA Championships level
Clear selection
When you are inside pack referee, where are you comfortable?
Clear selection
NSO Certification level
Rate your ability as Head NSO
No experience
WFTDA Championships level
Clear selection
Rate your ability as Penalty Box Manager/Timer
No experience
WFTDA Championships level
Clear selection
Rate your ability as Penalty Tracker/Wrangler
No experience
WFTDA Championships level
Clear selection
Rate your ability as Scorekeeper/Scoreboard Operator
No experience
WFTDA Championships level
Clear selection
Rate your ability as Jam Timer
No experience
WFTDA Championships level
Clear selection
Are you available for the games following the scrimmages?
Clear selection
Online officiating resume link
Any additional information we should know?
Submit
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