Eau Claire Youth Hockey Scholarship Application

Eau Claire Youth Hockey Scholarship Application

All information will be kept confidential. Scholarship recipients will be notified by phone before teams are formed.
Are you applying for a scholarship for more than one player?*

YesNo
Player's Name*

First NameLast Name
Player Level*

MiteSquirtPeeweeBantam
Are you requesting a full or partial scholarship?*

FullPartial
Player 2 Name

First NameLast Name
Player 2 Level*

MiteSquirtPeeweeBantam
Player 2: Are you requesting a full or partial scholarship?*

FullPartial
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*

Area CodePhone Number
As part of the scholarship program, you will be required to participate in the raffle ticket or coupon book sale. This is $350 for your first player and $100 for every player after that. We offer a payment plan for the fundraising effort.
If you are awarded a scholarship, do you need a payment plan for the fundraiser expense?*

YesNo
Do you qualify for ECASD subsidized lunch program*

YesNo
Did your player participate in travel hockey last season?*

YesNo
ECYH has limited scholarships available, and are awarded based on need. Please describe the circumstances that make this a player scholarship a necessity for your player and family*
Are you willing to fulfill the volunteer component of this program?*

YesNo
Please select the volunteer tasks you'd be interested in helping with:*

ECYH TournamentsTeam ManagerOther
I, parent/guardian name the parent or guardian of player(s) name(s)*, hereby accept the fundraising and volunteer requirements of this scholarship program sponsored by Youth Hockey Club of Eau Claire, Inc during the current hockey season. I assume all risks and hazards incidental to such participation and do hereby waive, release, absolve, indemnify and agree to hold harmless Youth Hockey Club of Eau Claire, Inc. I also agree to pay Youth Hockey Club of Eau Claire, Inc all net player fees due to them in the event I am unable to fulfill the fundraising or volunteer components of this scholarship program.
Signature*

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