World of the Wheels Tournament
Email address
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
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 Name & Relationship To You
Your answer
Your Derby Information & Experience
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! Simply paste your shared link below. See for the template or go straight to the template to create one to submit -
Your answer
Desired Role(s)
Are You Interested in being a Crew Head Official?
What work schedule do you prefer?
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-CHR)
Inside Pack (CHR)
Outside Pack
Jammer Ref
Alt / Announcer Ref
Penalty Tracker
Penalty Wrangler
Jam Timer
Scoreboard Operator
Penalty Box Manager
Penalty Box Timer
Line-up Tracker
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