Rookie Series: 2019-20 Training Program
You will need to complete ALL steps for full, successful registration. You will not be able to complete this form without stating your CRDi Insurance number.

1) Register for 2019-20 CRDi Skater Insurance.
Go to:
Follow all steps listed on the website, including payment and
print off/fill out Form C.
Wait for your insurance number to be e-mailed to you.

2) E-mail transfer your payment ($200) to:

In the payment comments/description, please note that it is payment for the 2019-20 training class.

No question/answer is needed for the etransfer.

3) Fill in this form.

**If payment arrangements need to be made for the course specifically, please contact: BEFORE filling out this form**

Email address *
Legal Name (First, Last) *
Your answer
2019-20 CRDi Insurance Number *
Your answer
Phone Number *
Your answer
Emergency Contact (Name and Number) *
Your answer
Previous Skating/Roller Derby Experience? *
Comments? Questions? Concerns?
Your answer
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