Playing for Keeps

Playing for Keeps Application
All form fields must be filled out completely for your application to be submitted.

You will be able to save your work should you need to exit the application before submitting. It is not advisable to fill out this application on a public computer.

Have the following documents on hand before starting this application:
- Proof of income for all parents/guardians who live in the same household must be provided. Acceptable proof is your current CCB (Canada Child Benefit) Your Benefit Notice is provided by the Federal Government annually in July. Visit our program's page on our website to learn how to obtain this form.
Please be advised that processing of your application may take up to 3 weeks to complete and longer in busier times of the year. If your application is approved funds will be sent directly to the Organization within 2-3 weeks.

Funding amounts available for PFK applicants is up to $200 semi-annually (Jan to June and July to Dec) per calendar year. Funding for PFK applicants is not to exceed $400 per year.

Section 1. Participant Information

Applications for children/youth up to age 21 are invited to apply
What county does the participant reside in?*

Hastings CountyNorthumberland CountyPrince Edward County

Child's Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Age*
Has the child/applicant above received funding from The Children’s Foundation in 2025?*

YesNo
Which program did the child receive funding for?

Parent/Guardian's Information
Parent or Guardian's Name*

First NameLast Name
Address*
City*
Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Is there a second parent or guardian in the household?*

yesno
Please provide names of all Parents/Guardians in the household
How many children live in the household?*
If there is more than one child in the household, what age are they?
Add all ages, separated by comma.

Section 2. Highland Shores Children's Aid
What is your worker’s name?
If applicable
Worker's email address
example@example.com
Do you currently have an open file involved with the Highland Shores Children’s Aid Society?*

YesNo

Section 2. Qualifying Criteria
Annual GROSS Household income before taxes.*
Per your current Income Tax return for all individuals.
I receive the Canadian Child Benefit or CCB for my children.*

YesNo
Please attach your current CCB (Canada Child Benefit) Benefit Notice. (Acceptable file formats: pdf, jpg, jpeg, png, screenshots) Visit our program's page on our website to learn how to obtain this form.*

Cancelof

If yes, please attach a copy of your ODSP or OW slip (acceptable file formats: pdf, jpg, jpeg, png)

Cancelof
Section 3. Program Organization Information

Program organization name, such as the YMCA, Quinte West Soccer Club, etc.
Program Organization Name *
Name of the Organization where your child will be participating in sports, arts, music etc.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organization email*
example@example.com
Contact telephone*
Type of activity*
soccer, music, art, cheerleading etc
Approximate start date of activity*

MonthDayYear
Date
Approximate end date of activity*

MonthDayYear
Date
Total registration cost*
The total cost for the length of the program.
Amount Funded
Previous funding for the current year.
This registration is for (pick one)*

One session (ie. one program for a set number of weeks) or,Ongoing sessions (program runs all year, weekly lessons etc)Other
Is there anything else you'd like us to know?
Internal Comments
The Children's Foundation is a donor supported Organization. How will this funding impact your child and family positively?*
What types of sports, programs, training, camps would your child like to participate in? Please give us an idea of what your child would love to participate in
i.e. tech camps, life skills, sensory play, age-appropriated dances etc.
Invoice I.D. #
Amount funded
Date Funds mailed

MonthDayYear
Date

Section 4. Permissions & Signature

Almost done!
I have thoroughly read and understand the guidelines of Playing for Keeps and agree that this application meets the guidelines and is truthful.*

Yes
I give The Children's Foundation permission to contact me for testimonials and impact stories.*

YesNo
Guardian Signature*

Clear
Date signed*

MonthDayYear
Date
If you have any questions about this form, please submit an email to info@thechildrensfoundation.ca
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