WRDL Spring Open Scrimmage - Skater Registration
April 30, 10-5 pm, 17 Wing, Winnipeg, MB

REGISTRATION CLOSES ON APRIL 13. Late registration will not be accepted due to the security gate list at our practice space. If you are unsure if you can make it, please register anyways, then let us know by the week of if you are unable to attend.

$15 registration fee is due on the day of
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Legal Name *
Derby Name
Skater Number *
E-mail Address *
Home League
Skater Insurance Number (RSC, CRDI, WFTDA, etc) *
Parent/Guardian's Name: (Juniors Only)
Parent/Guardian's Phone Number: (Juniors Only)
Skater Level *
I would like to skate in: (Check all that apply) *
Required
My first choice is: *
Please list all non-registered skaters, parents, guardians, siblings, anyone who might be in the vehicle with you when you are entering the 17 Wing Base. If you are travelling with another person who has registered to skate, we already have their name. EVERYONE MUST HAVE (PHOTO) ID TO GET ACCESS TO THE BASE.
Emergency Contact (Name & phone number) *
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