Badfish Roller Derby - Shenanigans Scrimmage Skater Sign-up, 8/15/26

Join Badfish for the second game in our Double Header Extravaganza! It will be a shenanigan-style open scrimmage. Skaters must be cleared for contact in order to participate.

$10 Skater Fee
8/08 Sign-Up Deadline.

Team assignments will be sent on 8/10. 

Scrimmage colors: black vs. white. 


Event Day Schedule
11:30am Shirts v. Skins Call Time 
12:00pm Scrimmage 1: Shirts v. Skins 
1:00pm Shenanigans Call Time 
1:15pm Scrimmage 2: Shenanigans 
2:15pm Post-Scrimmages Potluck! 

Venue
El Dorado Basketball Courts
2760 E Barrios Street 
Long Beach, CA 90815

Sign in to Google to save your progress. Learn more
Legal Name *
Derby Name
Number *
WFTDA Insurance Number *
Email Address  *
Phone Number  *
Skill Level *
Required
Which position(s) can you play or want to play? *
Required
Medical: It is the responsibility of the undersigned to ensure that the above-named person is medically fit to participate in strenuous on-rink or off-rink activities. Participation in roller derby activities, as in any sport, presents a risk of injury to person or property. The undersigned certifies that the above-named participant has no known conditions that prohibit or limit participation in any derby/skating activities held by or in association with Badfish Roller Derby. Additionally, the undersigned must have a WFTDA membership and/or primary insurance to cover any expenses related to any potential injury that may arise from participation in Badfish Roller Derby events. *
Required
Indemnification and Risk Acknowledgment: In consideration of being allowed to participate in any practices, competitions, or related events and activities, of the Badfish Roller Derby athletic sports programs, the undersigned acknowledges, appreciates and agrees that:
1. The risk of injuries from activities involved in this program is significant, including the potential for permanent paralysis and death, and while strict rules, equipment, and personal discipline may reduce such risk, the risk of serious injury remains; and,
2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others. I assume full responsibility for my participation; and,
3. I willingly agree to comply with the stated and customary terms and conditions for participation. However, if I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official, trainer, skating facility employee, and members of the Badfish Roller Derby Board of Directors immediately, and,
4. I, for myself and on behalf of my heirs, assignees, personal representatives and next of kin, HEREBY RELEASE AND HOLD BLAMELESS Badfish Roller Derby, El Dorado Park, Long Beach Park and Rec or any other rinks hosting practices and competitions, coaches, trainers, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors and advertisers (at of which are herein referred to as 'releases’) WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM NEGLIGENCE OF THE RELEASEES OR OTHERWISE. *
Required
Conduct: Because of the dangers of participation in roller derby, I recognize the importance of instruction given regarding playing techniques, training, rules of the sport, or to the team rules, and to obey these Instructions. I will not participate in any Badfish Roller Derby practice or competition under the influence of legal drugs or alcohol. If I am prescribed medication by a certified medical physician which may impair my judgment or affect my ability to participate in strenuous activity, I will seek medical consultation about my ability to participate in athletic activities, inform the trainers and team coordinators of the Badfish Roller Derby league of my medical condition, and opt not to participate if I believe there are risks to my health or the safety of others. I accept responsibility for purchasing and maintaining required safety equipment. Spectators (patrons on the premises as a result of your involvement in the roller derby) as well as participants must behave in a respectful manner to both person and property. Behavior which could potentially lead to intentional or unintentional bodily injury or injury to property will not be tolerated. *
Required

I have read this release of liability and assumption of risk agreement, understand its terms, understand that I have given up substantial rights by signing it, and do so freely and voluntarily without any inducement.

 *
Required
Please use the below QR code to pay the skater fee.  *
Captionless Image
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms