WFTDA Insurance is proud to provide coverage for RollerCon 2018 attendees whether they are skating only flat track or throwing banked track opportunities into the mix. This year you can register for your insurance in advance and skip the lines at RollerCon by using our new online process.
We have laid out all the information on how to complete this form and hopefully have answered all questions on this page, however, if you have any questions about this insurance purchase please email firstname.lastname@example.org.
Please complete the application for coverage below. To finish the process, submit payment for your purchase via Paypal to email@example.com within 24 hours of completing the form.
Incomplete or inaccurate forms will not be processed. Completed forms without payment will not be processed. If you do not receive your ID number within 30 days, your application has not been processed for one of the reasons above.
WFTDA Insurance is only accepting Paypal, which must be submitted within 24 hours of completing the form. The Paypal email address for this account is firstname.lastname@example.org. Your ID number will be emailed to you within 30 days of receiving your payment.
For Flat Track only: Send $26 via Paypal ($25 + $1 Paypal processing fee).
For Flat Track + Banked Track: Send $31 via Paypal ($25 flat track + $5 banked track + $1 Paypal processing fee).
For 2018 WFTDA Insurance Personal Accident Coverage customers looking for only additional banked track coverage: Please select Banked Track on the form below and send $6 ($5 banked track fee + 1 Paypal processing fee).
Note: Purchasing only Banked Track is only available to current WFTDA Insurance Personal Accident Coverage recipients, meaning you have coverage through WFTDA Insurance for your general flat track roller derby participation.
If you do NOT have WFTDA Insurance (as your insurance for roller derby) you may not purchase only banked track only coverage.
Anyone covered under this insurance agrees to comply with the WFTDA Risk Management Guidelines
If you are injured while covered under this insurance, an Injury Report Form must be completed within 14 days of injury.
Real. Strong. Athletic. Revolutionary.