LEATHER & SPICE

(and nothing too nice)

Registration

**$1.00 from each registration will be donated to the Biker's Reunion

Each game will be a black and white scrimmage. Please bring both a black shirt and a white shirt with derby number clearly marked.

E-transfer details:

Email all e-transfers to targ.rep@gmail.com

Question: What's the best event?

Answer: bikersreunion

Player Information

Real Name *

Derby Name and Number: *

Chapter: *

Insurance Number: *

Email Address: *

Phone Number: *

Home Address: *

Emergency Contact Name and Number: *

Health Concerns/Allergies: *

Please select the game times you will be able to attend (teams will not be announced in advance) *

Friday, 6-8 p.m.

Saturday, 10-12 p.m. (co-ed)

Saturday, 1-3 p.m.

Saturday, 4-6 p.m.

Registration Fee *

Player ($15)

Ref (No Fee)

NSO (No Fee)

Please select your skill level: *

Advanced

Intermediate

Beginner

How will you be paying? *

Will pay at the event

E-transfer

I am a ref/NSO and my fee is waived