Membership Application

Type of Membership (Competitive Skater, Non-competitive Skater, Non-skating Member

Do you have skating or sports experience?

Why would you like to join the Synergetic Sweethearts Roller Derby?

Do you have any medical or physical issues or conditions that would affect your ability to play roller derby? If so, please explain the condition. Failure to provide information about medical or physical issues or conditions will void SSRD from any responsibility pertaining to those conditions.

SSRD Member Application

To apply, please take the time to fill out the information below.