Parlor City Roller Derby Open Gender Mixer Sign-Ups

Parlor City Roller Derby Open Gender Mixer Sign-Ups

Location: Visions Arena, 1 Stuart Street, Binghamton, NY 13901

Ruleset: WFTDA

Level: B/C level

Who should participate:

All genders welcome
Skaters, refs, NSOs

Arrival Time: Between 2:30 PM and 3 PM

Required: Black & White Jersey

Note: Our August 15th mixer is a “Call the Shots” game, meaning, rules can change at any moment based on audience votes. You may be required to play under unusual conditions. Be prepared for a chaotic, unpredictable, and hillarious bout.

Civilian Name*

First NameLast Name

Pronouns*

Email Address*

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Derby Name*

Home League*

What are you signing up to do*

Derby Number*

Insurance Number*

Type the Insurance carrier (WFTDA or USARS) and the ID#

May 30th - Spring Sting MixerJune 20th - Parlor City vs. The WorldJuly 18th - Battle of the BoutfitsAugust 15th - Call the Shots

Slots are limited. To secure your spot, payment is due upon registration.

***Mixer fees can be refunded if you are unable to attend

Select payment option*

Non-PCRD Skater

Please enter the number of mixers you are attending

$15.00 Quantity

PCRD League Member

Please enter the number of mixers you are attending

$ Free Quantity

Total

$0.00

Payment Methods

Fastlane Checkout

Choose from one of the PayPal options to make your payment.

Contact Info

Payment Info