Personal Information

Pronouns


Do you have a derby name? yes no


18+?

Derby Name

You must be 18 Years to Join the team.

Do you have WFTDA insurance?

yes
no

WFTDA insurance number

Do you have any previous Experiance?

yes
no
League Affiliation

Team Name

City
State
Position
Jersey Number
Start Date
End Date

The Cedar Rapids Roller Girls have gear if you would like to borrow some. Please select any gear you would like to borrow, and the size you are requesting.

Do you have a helmet?

Yes

No

Choose a Bucket size

Do you have wrist guards

Yes

No

Choose a Wrist Guard size

Do you have elbow pads

Yes

No

Choose a Elbow Pad size

Do you have Knee Pads?

Yes

No

Choose a knee pad size

Do you have Skates?

Yes

No

Choose a shoe size

The Cedar Rapids Roller Girls hold two practices per week.
On Sundays we practice at 7:00 PM at the Vinton Skate & Activity Center in Vinton, Iowa.
On Wednesdays we pratice at 7:30 PM at GameOn Sports CR in Cedar Rapids, Iowa.

Please pick a Sunday or Wednesday

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Vinton Skate & Activity Center

1703 C Ave,
Vinton, IA 52349

The Vinton Parks & Recreation Department offers a vast selection of recreational and enrichment activities for residents of all ages and abilities. The department also operates many facilities and amenities including the Recreation Center, Skate & Activity Center, Miniature Golf Course, Vinton Community Swimming Pool, a splashpad, and many acres of parks, playgrounds and trails.

Vinton Skate & Activity Center

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GameOn Sports CR

4655 Tower Terrace Rd,
Cedar Rapids, IA, 52411

The vision at GameOn Sports is to establish a destination that delivers world class athletic and event facilities promoting community, competition, and connections. We are thrilled to partner with GameOn for bouts and practices.

Game On Sports
test form 4

Please sign your name here.


Are you ready?

By submitting this form, you are stating you are ready for fast paced action and skates thundering on the track

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