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CINA Individual Registration Form 
2025-2026 CINA Member Registration Form
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First Name *
Surname *
Address *
Zip Code
Email *
Telephone (Mobile and/or Home) *
Date of Birth  *
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Gender *
Club Name  *
Do you have any medical conditions we should be aware of? *
If yes, please state medical condition(s) or type N/A *
Select Your Category From The List Below  *
Required
Employment Status *
Nationality  *
Are you any of the following? *
Required
If you are an official from the list above, please note any qualifications and/or awards or type N/A *
Would you be interested in being an official for the CINA Upskills workshop programme? If yes, please tick from the options below. If no please select I do not wish to be a part of the upskills programme: *
Required
Are you interested in becoming a volunteer? *
Do you consider yourself to have a disability?  *
If "Yes", what is the nature of your disability or if "No" select "No"?  *
Required
Information Request

Your details will be held on the CINA databases but will not be used for any commercial purposes.  

Please tick the box the appropriate box below to confirm if you wish to receive netball information from CINA, please tick the box below:
 *
Required
To help promote CINA, official photographs/videos may be taken at coaching sessions and competitions.  These photographs may be used internally for netball publications or in the local press. 

Please tick the appropriate box below to confirm if you consent to your child’s picture to be taken:
Players Name: *
Player/Parent Signature (please type your full name as a digital signature) *
Date: *
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