Connecticut Roller Derby Travel Team Double Header

Host: Connecticut Roller Derby
Date: June 27, 2026
Location: Patsy DiLungo Veteran's Memorial Ice Rink, 71 Hudson St., East Haven, CT

Thank you for your interest in officiating with Connecticut Roller Derby!

Application

This application includes information from your profile.

Derby name

Legal name

Pronouns

League affiliation

Game history URL

Insurance

WFTDA NSO certification level

WFTDA SO certification level

This application covers multiple games.

Games

Game 1 (4:30 p.m.–6:30 p.m.)

Game 2 (6:45 p.m.–8:45 p.m.)

Choose the roles you're interested in filling.

NSO

Phone number where we can reach you. This will not be shared, it is for emergency situations (such as last minute unforeseen cancellations) only.

Notes/Comments/Allergies/Goals/Anything else?