Memorial Day Mayhem Officials Sign-up!
Officials sign-up for the Memorial Day Mayhem junior roller derby event, hosted by the Chick Whips of Topeka, KS.

NOTICE - As of May 29, the majority of the referee positions have been scheduled to those who signed up early. Please consider signing up for NSO positions at this point. Any referee position requests at this point are not guaranteed.

All officials should be on premises at least 30 minutes before their bouts are to begin. Thanks!

Dates: May 27 - 29, 2017
Saturday, starting at 5:30 PM ending by 10:30 PM (3 bouts)
Sunday, starting at 8 AM ending by 10 PM (7 bouts)
Monday, starting at 8 AM ending by 6 PM (5 bouts)
Location: Sk8away, 815 SW Fairlawn Rd, Topeka, KS 66606

Evaluations will be available upon request - just let me know. If so, please bring your form with your personal information already filled in and I'll fill in my part and submit to the JRDA.

THR: el Pea (Rick Steele)
THNSO: Brawlin' Barbie (Jessie Cummings)

Staffing selections and invites will begin going out by May 10th, 2017. Applications received by this date will receive primary consideration. This will be a Round Robin-style event, guaranteeing three sanctioned games per team. This the link for the event - https://www.facebook.com/events/419142715141301/

There are some fabulous teams traveling many many miles to participate so we need to provide THE BEST officiating possible during the event. Let's make it memorable for everyone!

Participating Teams:
SDG Butcher Babes - Greeley, Colorado
Chick Whips - Topeka, Kansas
Gotham Girls Junior Derby - Brooklyn, New York
Philly Roller Derby Juniors - Philadelphia, Pennsylvania
The Rolling Rebellion - Lewisville, Texas
Sirens of Savannah - Savannah, Georgia
SoDak Attack - Sioux Falls, South Dakota
TXJRD - Austin, Texas
JUST ADDED! - Rocky Mountain Rollerpunks - Denver, Colorado

Hope to see you soon!

Personal Information
First Name (legal)
Your answer
Last Name (legal)
Your answer
Derby Name
If you use your legal name, please enter it again.
Your answer
E-Mail Address
You will not receive our follow up emails if you mistype your address or provide an address that you never check. If you are accepted, but we cannot contact you, your acceptance will change to a rejection. Please make sure to triple check this one!
Your answer
Phone Number
Your answer
Medical Information
In the event that you cannot speak for yourself: allergies or any other conditions about which a paramedic might need to be aware (enter NONE if not applicable or if you feel strongly about privacy and understand the possible consequences of any omissions).
Your answer
Emergency Contact Phone Number
Your answer
Emergency Contact Relationship To You
Your answer
Your Derby Information & Experience
Insurance
If insurance info is not provided, your application will be reviewed for NSO positions only.
Insurance / Member Number
Required for skating officials. If you are applying as a non-skating official only, please just enter N/A
Your answer
Link to WFTDA Officiating History
Only modern WFTDA Officiating Histories will be accepted. Be sure it is public (visible to anyone with the link). If you do not have one, I encourage you to create one! Your application will not be strongly considered without it. If you do not have one (young junior refs, for example) please write "JUST STARTING" below to be considered for shadowing. Simply paste your shared link below. See wftda.org/officiating for the template or go straight to the template to create one to submit - https://docs.google.com/spreadsheets/d/1mXjmiZ-LGFl9LBHKWwdnxXvm1yAw4PuO9o97Z_3T7tM/edit#gid=1579335799
Your answer
Desired Role(s)
Are You Interested in being a Head Official?
Officiating Position Requests
What positions would you be willing and able to do for this event?
Yes please!
No, thanks.
Can if needed in a pinch!
Inside Pack (non-HR)
Inside Pack (HR)
Outside Pack
Jammer Ref
Alt / Announcer Ref
Penalty Tracker
Penalty Wrangler
Jam Timer
Scorekeeper
Scoreboard Operator
Penalty Box Manager
Penalty Box Timer
Line-up Tracker
PT/LT
Alt NSO
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