Tournament Matchup Submission Single Game MatchupBy submitting the information below, I, as an, authorized representative of the host league, am requesting the MRDA Games Committee to review the information provided and confirm this game for MRDA sanctioning. Please note: you will need to submit this form for each sanctioned game.Tournament Name Representative Name* Representative Email* Event Date* MM slash DD slash YYYY Home Team Name-- Select One --Atlanta Men’s Roller DerbyAustin AnarchyBarrow InfernosBototos BandidosBorderland Bandits Roller DerbyBridgetown Roller DerbyBrisbane City RollersCapital City HooligansCapital District Trauma AuthorityCarolina WreckingballsCasco Bay Roller DerbyChicago Bruise BrothersChinook City Roller DerbyCleveland Guardians Roller DerbyCollision Roller DerbyCrash Test BrummiesDenver Ground ControlDetroit Men’s Roller DerbyD.H.R. Men's Roller DerbyDisorderFlour City Roller DerbyGlasgow Men’s Roller DerbyGolden State HeatGranite City BrawlersHarm City Men’s DerbyHelsinki Coast Quads Roller DerbyHouston Men’s Roller DerbyKansas City SlaughterKent Men’s Roller DerbyLane County ConcussionLight City DerbyMagic City MisfitsManchester Roller DerbyManneken BeastsMen’s Roller Derby JapanMohawk Valley Roller DerbyMontreal Men’s Roller DerbyNew Orleans Brass Roller DerbyPanam SquadPhiladelphia HooligansPittsburgh Roller DerbyPuget Sound Outcast DerbyRace City RebelsSaint Louis GatekeepersSan Diego AftershocksTexas Men’s Roller DerbyThe Inhuman LeagueToronto Men’s Roller DerbyTwin Cities Roller DerbyTyne and Fear Roller DerbyVancouver MurderVarsity Derby LeagueWheels of MayhemWisconsin United Roller DerbyHome Team Representative Home Team Representative's Email Away Team Name-- Select One --Atlanta Men’s Roller DerbyAustin AnarchyBarrow InfernosBototos BandidosBorderland Bandits Roller DerbyBridgetown Roller DerbyBrisbane City RollersCapital City HooligansCapital District Trauma AuthorityCarolina WreckingballsCasco Bay Roller DerbyChicago Bruise BrothersChinook City Roller DerbyCleveland Guardians Roller DerbyCollision Roller DerbyCrash Test BrummiesDenver Ground ControlDetroit Men’s Roller DerbyD.H.R. Men's Roller DerbyDisorderFlour City Roller DerbyGlasgow Men’s Roller DerbyGolden State HeatGranite City BrawlersHarm City Men’s DerbyHelsinki Coast Quads Roller DerbyHouston Men’s Roller DerbyKansas City SlaughterKent Men’s Roller DerbyLane County ConcussionLight City DerbyMagic City MisfitsManchester Roller DerbyManneken BeastsMen’s Roller Derby JapanMohawk Valley Roller DerbyMontreal Men’s Roller DerbyNew Orleans Brass Roller DerbyPanam SquadPhiladelphia HooligansPittsburgh Roller DerbyPuget Sound Outcast DerbyRace City RebelsSaint Louis GatekeepersSan Diego AftershocksTexas Men’s Roller DerbyThe Inhuman LeagueToronto Men’s Roller DerbyTwin Cities Roller DerbyTyne and Fear Roller DerbyVancouver MurderVarsity Derby LeagueWheels of MayhemWisconsin United Roller DerbyAway Team Representative Away Teams Representative's Email Venue Name* Street Address* Street Address 2 City* CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabweState*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCanadian Province*AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukonZip Code Other Venue InformationFurther InfoAt the completion of the game, the following steps must be taken for this game to count towards rankings:IGRF formThe signed IGRF form can be uploaded on the score submission form, or be emailed to sanctioning@mensrollerderbyassociation.com within 2 weeks of the game date.Completed Stats BookThe completed stats book can be submitted on the score submission form, or be emailed to [email protected] within 2 weeks of the game date and within 4 weeks of a multi-game event.VerificationBy submitting the enclosed information I am verifying that I have read and understand the steps needed for sanctioning. I also verify that the above games will be played by the most recent MRDA rule-set and the most recent Safety Protocols will be followed.Captcha