Financial Assistance Application

Financial Assistance Application 2024-2025 Season
The information on this application will be kept private and confidential.

PLAYER INFORMATION:
(For multi-player families, submit one form for each player):
Player Name*

First NameLast Name
Birth Date*

MonthDayYear
Player Gender*
2023-2024 Team *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
RESPONSIBLE PARTY INFORMATION:
Parent/Legal Guardian 1 - Name*

First NameLast Name
Parent/Legal Guardian 1 - Email*
Parent/Legal Guardian 1 - Phone Number *

Area CodePhone Number
Parent/Legal Guardian 2 - Name

First NameLast Name
Parent/Legal Guardian 2 - Email
Parent/Legal Guardian 2 - Phone Number

Area CodePhone Number
Marital Status*
Total # of Dependents in Household*
If you have additional circumstances that you would like the committee to consider (Example: unemployment, excessive medical bills, circumstances have changed since last tax return) please provide that explanation here.
Please Upload At Least One of the Following Items (Most Recent Tax Return, 2 of the Most Recent Pay Stubs, School Lunch Program Assistance Letter, or Medicaid Card)

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Person Completing this form*
First & Last Name
PLEASE BE SURE THAT YOU HAVE FULLY
COMPLETED THIS FORM FOR THIS APPLICATION TO BE REVIEWED.
Upload Your Tax Return & Last 2 Pay Stubs for :

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Should be Empty:

Financial Assistance Application 2024-2025 Season