PRNA Club Affiliation Form 2026

Club Name*

We wish to make application for annual membership to the Pine Rivers Netball Association Inc. with full membership rights.

Does your Club have a current constitution?*

YesNo

If yes please upload your current constitution

Name*

First NameLast Name

DOB*

Email*

example@example.com

Address*

Mobile*

Blue Card Number*

Blue Card Expiry date*

Netball Connect Number*

Financial Member in Netball Connect*

YesNo

Name

First NameLast Name

DOB

Email

example@example.com

Address

Mobile

Blue Card Number

Blue Card Expiry Date

Netball Connect Number

Financial Member in Netball Connect

YesNo

Name*

First NameLast Name

DOB*

Email*

example@example.com

Address*

Mobile *

Blue Card Number*

Blue Card Expiry Date*

Netball Connect Number*

Financial Member in Netball Connect*

YesNo

Name*

First NameLast Name

DOB*

Email*

example@example.com

Address*

Mobile *

Blue Card Number*

Blue Card Expiry Date*

Netball Connect Number*

Financial Member in Netball Connect*

YesNo

Name

First NameLast Name

DOB

Email

example@example.com

Address

Mobile

Blue Card No

Blue Card Expiry Date

Netball Connect Number

Financial Member in Netball Connect

YesNo

Name

First NameLast Name

DOB

Email

example@example.com

Address

Mobile

Blue Card No

Blue Card Expiry Date

Netball Connect Number

Financial Member in Netball Connect

YesNo

Name

First NameLast Name

DOB

Email

example@example.com

Address

Mobile

Blue Card No

Blue Card Expiry Date

Netball Connect Number

Financial Member in Netball Connect

YesNo

What nights does your club train?*

What times does your club train?*

Club Postal Address*

Club Email Address (Email address for all correspondence)*

example@example.com

Total Club Player Numbers*

Website*

Facebook and / or Instagram handle*

Please upload images even if you have supplied previously

File Upload

We accept that the jurisdiction of the PRNA shall extend to and be acknowledged by all affiliated Members.We accept the rights to veto of the PRNA who have the right to refuse any application without given reason.We accept that our Club will follow all constitution, policies, procedures, and requirements as outlined by PRNA and understand that non-compliance may result in our Club being disaffiliated, fined or sanction imposed.If accepted to membership of the PRNA, we pledge ourselves to uphold and keep in all sincere good faith and do everything in our power to further the objects and aims of the Association as set forth in the Constitution and Policies and Procedures.We declare that our club, or any of our Executive Committee Members, are not a member of any other Netball organisation having objects and aims in a way opposed, or in competition, to PRNA.We acknowledge that PRNA, or any of its management, will not be responsible for any injuries incurred by players, umpires, officials, or spectators whilst on Association grounds, or whilst representing the Association at State or Inter Association Carnivals.We acknowledge that it is up to our Club to view official documents of players to prove date of birth, in order to avoid any accusations of cheating.We provide our uniform (including dress, bike pants, playing shirt or playing shorts) to be worn by our members at all fixture rounds during the season, or loss of points will be accepted.We agree to be financial with the Association prior to round 6 of the Winter Season and round 1 of Summer Night Season.

PRINT NAME*

POSITION HELD WITHIN CLUB*

SIGNATURE*

DATE*

Date

EFT DATE OF PAYMENT

Date

PRNA BANK DETAILS:

Pine Rivers Netball Association Inc.

Bendigo Bank

BSB: 633 000

Account No: 192 796 480

Reference use AFF (Club Name)

PINE RIVERS NETBALL ASSOCIATION

CLUB AFFILIATION FORM - 2026 ALL NOMINATIONS AND FEES FOR AFFILIATION MUST BE RECEIVED AND APPROVED PRIOR TO REGISTRATION OF TEAMS FOR 2026

Club Information