Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Parent/guardian name*

Co-parenting family? Please give contact details of other parent/guardian

What program/s will you be participating in?*

Junior Learn to Skate (Junior Rollers) 12.30-1.30pm

Junior Roller Derby 1.30-2.30pm

both programs (12.30-2.30pm)

Are you an Ambulance Victoria member? (GRRD Club Policy is to call an Ambulance if injuries sustained exceed those our Level 2 First Aiders can treat)*

Please list your Emergency Contact Name & Phone Number*

Do you hold a Level 2 First Aid Certificate?*

If you have any pre-existing injuries or information you would like shared with your trainers, please list here: Max. 255 characters

Do you have pronouns you'd like to share with us?

If you require Gear Hire, what items do you require?

Helmet

Pads

Skates

If you require Skate Hire, please list your shoe size

Mouthguards are compulsory. You can bring your own, or select the relevant Registration for a skate specific mouthguard to be provided at your first session.*

As a volunteer run sport we ask parents if they are comfortable being identified as a first aider during sessions should we require First Aid*

I have my First Aid and am happy to be a First Aider

I am happy to be a First Aider however don't have a valid certificate

I am not interested in this role

We will be taking photos to be used for promotion on Facebook - do you consent to your child/teen's image being used on social media?*

Yes

No

Please check with me first

To ensure the safety of skaters, we require adults to enter the building to collect skaters (instead of them walking to carpark to meet you)*

Yes I understand

Does your child/teen have adults they are NOT to be collected by? Please email us relevant details if this is the case - juniorrollers@gmail.com*

Yes (I will email details)

No

HAVE YOU BEEN REFERRED BY SOMEONE? PLEASE LET US KNOW WHO AND YOU BOTH GET A DISCOUNT CODE FOR TERM 1 2025!

Select registrations

New Skater - Registration ONLY

$20.00 ea

Login required

Returning Skater - Registration ONLY (bringing own gear)

$20.00 ea

Login required

Returning Skater - Registration & Skate / PPE Hire

$30.00 ea

Login required

Terms Of Registration

Gippsland Ranges Roller Derby (GRRD) prides itself on being inclusive, welcoming and supportive and a huge part of that is our Code of Conduct (listed below). Registration for a GRRD Event acknowledges that you have read and agree to follow our Code of Conduct and allows us ensure our club remains a safe, fun and inclusive space for all.

GRRD Code of Conduct
WE AIM TO: Ensure all skaters and trainers feel safe, supported and excited to be part of our club.
WE WILL: Develop a consistent culture of inclusion, professionalism and respect between skaters, trainers, and our community, across all venues, on and off the track.

WE HAVE:
EQUALITY: all members are equal and everyone has a right to have a say.
RESPECT: for all skaters and trainers - we show timeliness, listen, don't groan. Gossip and sharing information about people's private business is not a part of our club's culture.
PROFESSIONALISM: trainers are prepared, skaters come to train.
BOUNDARIES: sexualised language and non-essential touching are not acceptable.
COMPASSION: we use supportive and encouraging language and remove the 'be tough to play derby' ethos.
SELF-AWARENESS: skaters communicate with trainers and take breaks when necessary (drinks, injury, stress).
SELF-REFLECTION: feedback is important & we appreciate different learning styles.
GOALS: we set our own skating goals and share them with trainers.
ATTITUDE: we maintain a positve attitude and are aware of our mental health.
SAFETY: skating is a safe sport - injuries will be reported before the end of a session.
RULES: we always use appropriate levels of contact in training.
VALUES: we are a family friendly club - swearing is not appropriate when children (under 18) are present.

USING THE CODE
1. TIME OUT: If something is happening against the Code of Conduct and people are uncomfortable, ANYONE can call Time Out for immediate action.
2. WHO SPEAKS? All members have the right and confidence to speak up.
3. WHO SUPPORTS? The Skater Rep at each location can act as intermediary or support between the trainer and the skaters, if required.

I confirm that I have read the above Terms Of Registration in its entirety.*

I agree to the Terms Of Registration.*

Term 4 Junior Skate Program (both streams register here)

Already a member?

Details

Basic details

Additional information

Select registrations

Terms Of Registration

Term 4 Junior Skate Program (both streams register here)

Already a member?

Details

Basic details

Additional information

Select registrations

Terms Of Registration

All dates