Dues/Payments

NOTE: Dues paid ON OR AFTER the 15th of each month are considered late!!!

For questions or concerns regarding your dues payment, you can e-mail a copy of your receipt, along with derby name/dues month to: jrdbod@gmail.com

Name *

First

Last

Email *

Do you have a derby name? *

• Yes
• No

Enter your derby name *

Select your skater type: *Active Skating MemberActive Skating MemberActive Skating Member (LATE)Fresh Meat MemberFresh Meat Member (LATE)Leadership MemberLeadership Member (LATE)LOA / Retired Skating MemberLOA / Retired Skating Member (LATE)Officials / Coaches / StaffOfficials / Coaches / Staff (LATE)Visiting / Drop-in Skater

Select Dues month you are paying: *

• January
• February
• March
• April
• May
• June
• July
• August
• September
• October
• November
• December

Dues paid separately for each month

Total

$ 0.00

Enter Credit/Debit Card info *

Card

Name on Card

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