SRDL Skater Development Program (Level 1) August 2019

Before we can get you on the track, we need you to fill in some paperwork.
Please complete all sections listed below.

Legal Name *
Your answer
Preferred name:
Your answer
What do you go by on Facebook?
Your answer
Email address *
Your answer
Date of Birth *
Postal Address *
Your answer
Contact Phone Number *
Your answer
Are you an Indigenous Australian, or a First Nations person from another country?
Sydney Roller Derby League is committed to finding ways to address the lack of representation for Indigenous people in our sport. With this in mind, we are waiving our $120 course fee for Indigenous skaters to join our Level 1 Introduction to Skating Course. On the next page, if this applies to you, please only transfer payment for the Skate Victoria Membership (our compulsory insurance provider). If you have any questions, please contact
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