11/9/2025 JRD Charity Game

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🐾 Help Us Support Jacksonville’s Furry Friends! 🐾

🛼 Roll with the Jacksonville Roller Derby League for a high-energy charity game benefiting the Jacksonville Humane Society!

This game is open to all Level B and Level C roller derby skaters from any league for a $10.00 drop in fee. A portion of the collected drop in fees will be donated to the cause.

Are you ready to skate for fur baby forever homes:

✏️ Sign up below and pay drop in fee by November 1st to be rostered.

💸 Drop in fee of $10.00 can be purchased HERE

📨 Watch your email for any important information that may need to be communicated before the game day.

🌐 Watch our Facebook Event page for the roster posting after Nov 1st to know what team you are on and what color to wear.

🐾 Let’s pack the house, raise some tails, and show that derby love extends to four-legged friends too! 🐾

Email *

Your Legal Name *

Your Derby Name

Your Jersey Number

Your Home League *

Jacksonville Roller Derby League

Other:

WFTDA Insurance Number (if MRDA, please provide coverage information to be confirmed) *

Emergency Contact's Name and Phone Number *

My preferred position(s) is..... *

Jammer

Pivot

Blocker

Anywhere, just put me in coach!!!

Required

What is your skill level? (anyone playing in this scrimmage is expected to have passed WFTDA's basic skills assessment with a WFTDA registered league) *

"B" - I have skated in a game at least three times before

"C" - I have skated in only one or two games before

Beginner - I have only scrimmaged before, but have not played a game yet.

New Graduate - This will be my first game; I have not played in a game yet.

Other:

Preferred team color to wear.

(Please bring both incase we have to do a last minute change to the rosters, but we will do our best to accommodate your team preference)

Black jersey with my number on the back

White jersey with my number on the back

Just put me in coach!! (I do not have a preference)

I understand that a drop-in fee of $10.00 is required by November 1, 2025 to be rostered for this game. Payment link *

I have paid the drop in fee.

I will pay the drop in fee by November 1st....I promise.

I am a JRD league member, so I do NOT pay a drop-in fee.

By entering your full, legal name below, you have read and understand the Jacksonville Roller Derby's Code of Conduct. I also agree that I release any representatives, agents, and successors of Jacksonville Roller Derby, INC. from liability related to injury or illness I may incur as a result of participation in said physical activity. I hereby assume all risks connected therewith and consent to participation in said activity. *

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