OFFICIAL ENTRY FORM
Better Living is teaming up with YOU to promote children’s health and support our community by offering a $1,300 EQUIPMENT GRANT to a qualifying Non-Profit Youth Sports program of your choice! Form must be completed in its entirety to be eligible.
Your Name
*
First Name
Last Name
Nominee
*
Email
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select One
Central Little League
Monticello Little League
Soccer Organization Charlottesville Area (SOCA)
Piedmont Family YMCA
Jefferson Swim League (JSL)
Jefferson District Youth Football League
Special Olympics – Area 3
Write In
Please Verify That You Are Human
*
Submit
Should be Empty: