Detroit Junior Roller Derby Sign Up
**USE ONE FORM FOR ALL CHILDREN IN YOUR FAMILY WHO ARE INTERESTED IN PLAYING**
Parent/Household Info
Parent #1 should be the primary contact for communication from Detroit Roller Derby
Parent/Guardian #1 Name *
Your answer
Parent/Guardian #1 E-mail Address *
Your answer
Parent/Guardian #1 Phone Number *
Your answer
Parent/Guardian #1 Address (Please include City, State and Zip Code) *
Your answer
Parent/Guardian #2 Name
Your answer
Parent/Guardian #2 E-mail Address
Your answer
Parent/Guardian #2 Phone Number
Your answer
Parent/Guardian #2 Address (Please include City, State and Zip Code)
Your answer
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