Ottawa Junior Roller Derby Registration Form: Winter-Spring 2019 Session
Welcome to the Ottawa Junior Roller Derby Winter-Spring 2019 session, administered by Ottawa Valley Roller Derby, the OJRD Coaching Committee, and the Coach-Guardian-Skater Association (CGSA).

OJRD is open to skaters aged 9-17 of any level of skating experience and any gender.

Email address *
Winter-Spring 2019 Session Information
The Winter-Spring Juniors session will run Saturdays 1-3PM from January 12th 2018 to June 15th 2019. From January 12th to April 27th, practices will take place at Ottawa Tech high school, 440 Albert Street. From May 4th to June 15th, practices will take place at the Rideau Curling Club, 715 Cooper Street.

There will be no practice on the following dates:
February 9th and 16th
March 16th, 23rd, and 30th
April 20th
May 18th

The coaching team will send you more information about the program structure and curriculum before the sessions begins.

Skater Information
Skater Last Name *
Your answer
Skater First Name *
Your answer
Skater Date of Birth *
Does the skater have any medical conditions or allergies? *
Your answer
Derby Name (if applicable)
Your answer
Derby Jersey Number (if applicable)
Your answer
Guardian Information
Guardian Last Name *
Your answer
Guardian First Name *
Your answer
Guardian Phone Number *
Your answer
Guardian Alternate Contact Number (if applicable)
Your answer
Email Address *
Please provide the address where you wish to be contacted - all registration updates will be sent to this address, and you're responsible for staying on top of the alerts we send you. Double check your spelling!
Your answer
Insurance Information
Does the skater have OHIP coverage? *
Emergency Contact Information
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Emergency Contact Relationship *
Your answer
Fees for the Winter-Spring session are $250.
I understand that the skater cannot participate until payment has been received. *
Please contact OVRD's Director of Finance if you have any questions or concerns about payment, at
Payment Method
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