Building Champions in Sports. Preparing Leaders in Life.

Youth Assistance

Parent/Guardian Name

First

Last

Parent/Guardian Email

Parent/Guardian Phone Number

Best number to reach you regarding this application.

Child/Athlete Name

First

Last

Child/Athlete Age

Child/Athlete Sport

Type of Assistance Requested

Please describe the assistance your child needs.

Please tell us what your child needs, the estimated cost (if known), and how this assistance would help them participate in sports.

Estimated Amount of Assistance requested ($)

Enter the estimated cost, if known.

Team, League, or Organization Name.

Enter the name of the team, league, or organization your child participates in or hopes to join. If none, enter N/A.

What is preventing your child from participating?

Please explain the financial or other circumstances making it difficult for your child to participate. Share only what you feel comfortable sharing.

Date Assistance is Needed By.

If there is a deadline, enter the date in MM/DD/YYYY format.

Amount director Foundation

Is the child related to a Foundation director or officer?

Parent/Guardian Acknowledgement

“I certify that the information provided is accurate to the best of my knowledge. I understand that submitting this application does not guarantee assistance and that the Foundation may request additional information.”