Your Name *

Your Email *

Phone Number (Parent/Guardian): *

Child's Name *

Child's Age *

School *

Household Information

Total Household Income: *

Number of People in Household *

Do you receive any government assistance? (e.g., SNAP, Medicaid, Housing) *

Why are you applying for financial assistance?

(Please explain any financial difficulties or special circumstances.)

Program Commitment

Program Season *

Program *

Has your child participated in this sport before? *

Will your child be able to attend all practices and games? *

Signature

By signing below, I confirm that the information provided is accurate and complete to the best of my knowledge.

Parent/Guardian Signature: *

Date: *

Please verify that you are a human.