Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.


  1. Private Swim Lesson Application
  2. Swim Lesson Evaluation
  1. RRR Exam

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

External Forms

  1. Employment Application Form

    Employment Application

  2. LED Outdoor Sign Request
  3. Request for Refund

    Class and membership refund form.

  4. 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. Inspirational Wellness Award Nomination Form

    Please complete this form to nominate yourself or another person for the 2020 Inspirational Wellness Award

  2. Membership/Daily Pass Donation Guidelines
  3. 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…


  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. 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…

  1. Invoice Request
  2. Time Off Request

Rock River Rapids

  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
  1. Rock River Rapids Facility Request
  2. Rock River Rapids Otter Party