Wicked Skatewear Roller Derby Rec League Interest Form
This fun and instructive recreational roller derby league is for all genders aged 5-17 at all skill levels. There is no competitive league affiliation and skaters may skate with other leagues. Rec league is for fun, exercise, and developing derby skills!

No experience necessary. Participants will learn how to skate and how to play roller derby. Weekly scrimmages will provide hands-on experience. Skaters will learn the rules of flat track roller derby and incorporate derby strategies in their game play.

Sessions will take place every other Sunday from 8-10 AM from May 12 - July 21.

Cost is $100 for all six sessions. A Wicked Rec League T Shirt will be provided to all participants.

Skaters must have the following equipment:

Quad Skates
Helmet
Elbow Pads
Knee Pads
Wrist Guards
Mouth Guard
Refillable Water Bottle

Some loaner skates and gear are available on a first-come-first-served basis. Skaters must bring their own mouth guard.

Contact us for more information: losanarchists@gmail.com, 323-609-3320
Legal Name *
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Derby Name
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Derby Number
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Phone
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Email Address
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Parent/Guardian Name *
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Parent/Guardian Phone *
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Parent/Guardian Email Address *
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Emergency Contact Name *
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Emergency Contact Phone *
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Current League
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Years Playing Derby *
JRDA Skill Level *
Level 1 allows positional blocking only. Intentional contact with an opponent is not allowed. Level 2 allows Lean Blocking only. Forceful Initial Contact is not allowed. After initial contact is made gently, blockers may apply force to legal target zones with legal blocking zones. Level 3 allows all contact otherwise considered legal.
T Shirt Size *
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Comments/Special Requirements
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