OMG Youth Sports Camp/ OMG Adventure Club Scholarship, Financial Aid and Grant Award Application Form

OMG Youth Sports Camp/ OMG Adventure Club Scholarship, Financial Aid and Grant Award Application Form
Child's Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Child's School:
Grade:
Which camp would you like to attend?: *
If attending an adaptive program, what is your child's diagnosis?

Additional Information
Child's Gender

MaleFemale
Monthly Family Income (Gross)
$
Please upload a recent pay stub, tax return, benefit letter, or other official proof of income—if you are currently unemployed, you may instead submit a brief written statement explaining your situation.*

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Additional Income*

Total Monthly Household Income*
Does your child attend a Title 1 School?

YesNo
If applying for a grades-based scholarship, please attach child's most recent report card:

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Are you currently receiving city, state or federal financial assistance, or tuition assistance?
Please explain the reason(s) you are applying for financial assistance with OMG Youth Sports.
Certification & Agreement

I certify that the information provided in this application is true, accurate, and complete to the best of my knowledge. I understand that providing false, misleading, or incomplete information may result in the immediate termination of any financial assistance awarded, and I will be responsible for the full cost of my child's participation in the program.

By signing below, I acknowledge and agree to these terms.
Name

First NameLast Name
Date

MonthDayYear
Date
Signature

Clear
Should be Empty:

Family Information