Form Center

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Aquatics

  1. Private Swim Lesson Application
  2. RRR Exam

    Complete this form to demonstrate your knowledge of the RRR training manual.

  1. Returning Aquatic Employee Questionaire

    All previous aquatic employees will fill out this form and submit it.

  2. Swim Lesson Evaluation

External Forms

  1. Autopay Membership Agreement
  2. Employment Application Form

    Employment Application

  3. Medical Release Form
  4. Physical Activity Readiness Questionnaire
  5. Request for Refund

    Class and membership refund form.

  6. Suggestion Box

    The Derby Recreation Commission would like to serve you and we would like to hear what you have to say. Please submit your input... More…

  1. Community Service Application
  2. LED Outdoor Sign Request
  3. Membership/Daily Pass Donation Guidelines
  4. Recreation Station Daily
  5. Request to Terminate Auto Pay Agreement

Fitness Center

  1. Fitness Pledge Form
  1. Wellness Hour Form

    New members are eligible for a wellness hour in the fitness center. DRC staff will provide a tour of the center and an orientation on... More…

Fundraising

  1. Julie Dombo Run Walk Donation Form

    Donations for Julie Dombo can be made on this form. Registrations for the event are taken on a separate form.

  1. Julie Dombo Run/Walk Online Registration Form

    Please fill this out and complete the online payment to register for the Run/Walk

Internal Forms

  1. Banner/Poster Request
  2. Invoice Request
  3. Returning Aquatic Employee Questionaire

    All previous aquatic employees will fill out this form and submit it.

  1. Employee Membership Enrollment Form
  2. Marketing Request Form

    To request a project or assistance, please fill out this form and be as detailed as possible. Please note that submitting this form... More…

  3. Time Off Request

Rock River Rapids

  1. Gift Cards

    Gift cards can be purchased for use on any Derby Recreation Commission or Rock River Rapids services with the exception of concessions... More…

  2. Rock River Rapids Facility Request
  3. Rock River Rapids Otter Party
  4. Rock River Rapids Season Pass Purchasing Form

    Please fill identify a recipient for each Rock River Rapids season pass purchased. The season passes will be set up and ready for you!... More…

  1. Returning Aquatic Employee Questionaire

    All previous aquatic employees will fill out this form and submit it.

  2. Rock River Rapids Group Information

    Use this form to request $1 off per customer for groups of 20 or more.

  3. Rock River Rapids Pass Donation Request