Peninsula Roller Derby - Double Header

Host: California Derby Officials
Date: June 13, 2026
Location: The Plex 800 Embedded Way San Jose, CA 95138 https://www.gotoplex.com/

Questions can be directed to cdo-leadership@googlegroups.com

Application

This application includes information from your profile.

Derby name

Legal name

Pronouns

League affiliation

Game history URL

Insurance

This application covers multiple games.

Games

Game 1 (3 p.m.–3:30 p.m.)

Game 2 (5 p.m.–6:30 p.m.)

Choose the roles you're interested in filling.

NSO

Emergency Contact Info

Do you have any food allergies that we should be aware of? We almost always feed the officials!

Is there any additional information you wish to provide, applicable to this application?