ARDL Member Form 2021
This form is for ALL people and their children, registering as an ARDL General Member or Associate (non-skating) Member with Albany Roller Derby League. All Membership is Term based.

ARDL General Member:
TERM4 2021
Starts October 14th
* Skate Like a Girl (Girls and non binary ages 12-17)**FULL***
* Roller Derby (all genders ages 18+)
* Junior Roller Skate (all genders ages 7-12) ***FULL***

ARDL Associate Member:
ideal for non skating coaches, volunteers, non-skating officials and supporters keen to get involved but not skate



All Members:
* Have a vote in AGM’s or Special Meetings
* ARDL Members Facebook page and email newsletter
* 10% discount at Car Smart - our sponsor

Under 18’s are not members but their parent or carer holds the membership.

Members do not receive discounts for boot camps, roller derby games, tournaments or other events held by Albany Roller Derby League.

Terms align with WA school terms.
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Email *
Your full name and pronouns if you like (she/her, he/him, they/them etc) *
Your Date of Birth (Day, Month, Year)
Your child's name (if they are the one participating in the program)
Child Date of Birth (Day, Month, Year)
Address *
Your phone number *
I consent to photographs being taken of myself/my child participating in programs and events *
Emergency contact name and phone number #1 *
Emergency contact name and phone number #2 *
Do you have Ambulance Cover ? *
Medical Information - Please list any medical information we may need to be aware of for yourself/your child (e.g. asthma, diabetes, epilepsy, allergies, chronic pain):
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