National Roller Sports Association RegistratioN

Adult Athlete Participant

Welcome to the 2025 National Roller Sports Association (NRSA) registration for adult athletes 18 years or older. This registration must be completed by the participating adult athlete.

The NRSA 2025 membership period begins January 1st, 2025 and runs through December 31st, 2025. The membership fee is $50 per participant, and includes a $25,000 Athletic Participation Insurance Coverage ($500 deductible applies). This policy acts as secondary coverage to any existing medical or health insurance coverage.

IMPORTANT: IF YOU WISH TO BE BOTH AN ADULT ATHLETE PARTICIPANT AND A COACH, REFEREE, OFFICIAL, OR VOLUNTEER FOR THE 2025 YEAR, YOU WILL ONLY NEED TO COMPLETE THE NRSA 2025 OFFICERS, COACHES, REFEREES, STAFF, AND VOLUNTEERS REGISTRATION FORM.

Adult Athlete Participant Information

First Name*

Middle Name

Last Name*

Suffix

Date Of Birth*

Email Address*

Address*

City*

State*

Zip*

Phone Number*

Please select your home rink, club or affiliated organization*

Roller Sports Discipline

Artistic Skating

Inline Hockey

Rink Hockey

Speed Skating

I agree to the terms and conditions above in the Athletic Waiver and Release of Liability.*

Agree

ATHLETIC WAIVER AND RELEASE OF LIABILITY

In consideration of being allowed to participate in any way in NATIONAL ROLLER SPORTS ASSOCIATION (NRSA) sports programs, related events and activities, the undersigned acknowledges, appreciates, and agrees that:

The risks of injury and illness from the activities involved in this program are significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and,

I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and,
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE NATIONAL ROLLER SPORTS ASSOCIATION, their officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.