RDC Travel Form - Proof of Insurance for Teams

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is to provide proof of insurance to another team or league in or outside of Canada.
As of January 2024 there will be a cost for each day of $4 per person per day for skaters playing roller derby outside of Canada. This is a special rate offered by Roller Derby Canada.

RDC travel insurance is only for use if you are playing with the Canadian team you are registered with. For skaters travelling as a single to boot camps, Rollercon, or attending a world cup event please use the RDC Travel Form - Individual Skaters travelling Out of Country.

RDC does not cover skaters crossing the border to play on a USA team. Please allow 7-10 days processing time. WFTDA may require up to 30 days in advance for sanctioned games.

Email *

Name of person filling out this form *

Name of the league applying for certificate. *

Name of League (team you are playing) requesting the Certificate and Address *

Location of Event *

Please provide the dates you are skating out of Country. *

What type of event will you be attending:

Please provide the name of the event if applicable.

Please provide each skaters Membership# and REAL name you need on the certificate use a comma to seperate. Please fill out the form for your whole team, including skating coaches, and skating officials. *

List any other email addresses that require a copy of this certificate.

Once we have processed your membership, we will send an invoice for the full league. Please provide a contact name and email so we can forward the invoice to the appropriate person.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Roller Derby Canada Services - RDC. Report Abuse

Forms