NCDA Membership Registration Form

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All Members of National Collegiate Dodgeball Association, Inc must fill out the short form below.

This form will be used to register our Members, compare game rosters with student registration status, and act as an acknowledgement to the policies of National Collegiate Dodgeball Association, Inc. Your contact information is secure. The NCDA will never sell it. The NCDA will not share it outside of administrative staff or the player's school staff.

First Name *

Middle Initial

Last Name *

Date of Birth *

ARE YOU SURE THE YEAR IS CORRECT?

YYYY

What gender do you identify with? *

Please self-identify your race *

Phone Number *

xxx-xxx-xxxx

Email Address *

Street Address *

City *

State *

Zip Code *

Primary Membership Status *

What will be your primary role in the NCDA?

Student [Active Player]

Official [Alumni/Inactive Player]

Administrator [Alumni/Inactive Player]

Staff Member [Alumni/Inactive Player]

Coach [Alumni]

Member Team Affiliation *

Which institution are/were you registered with?

Year Classification *

How many years have you competed in the NCDA? *

Major *

Estimated Graduation Date *

Month and Year are important, exact day is less imporant.

YYYY

Student Identification Number *

What is the student ID number your institution issued to you (alumni enter NA)?

Emergency Contact - Name *

Emergency Contact - Phone *

xxx-xxx-xxxx

Emergency Contact - Relationship *

I agree to the following terms and policies: *

By checking the boxes below, you hereby agree to the terms and policies of National Collegiate Dodgeball Association, Inc.

NCDA Release of Liability Policy [https://drive.google.com/open?id=1rZRDmTfa_RKEyL6GqzMl-HXGvIIWIY7o-Axm2V_N6lI]

NCDA Conduct Policy [https://drive.google.com/open?id=14QmpgzNrY2JEG-17MbsT3hBfG7KHNlpNUTjMjG05Uhs]

NCDA Bylaws [http://ncdadodgeball.com/about/bylaws-and-policies/ncda-constitution]

NCDA COVID-19 Guidelines [https://docs.google.com/document/d/1uO-9Rb8ck1ad0QzBV8JEjkc4dfAgmJlcgHqsIGg_6oc/edit?usp=sharing]

Required

Do you wish to participate in the NCDA's Member Networking Pool? *

The NCDA would like to help facilitate networking between players, coaches, and alumni of the NCDA. With members from schools all over the country and different walks of life, we would like to help connect you with those who have similar career goals, interests, or even questions. Select 'Yes' if you are interested in participating!

Yes

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