kyelite.org - LRYTL Income Eligibility Form
  • Registration & Scholarship Application 2024

  • Format: (000) 000-0000.
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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
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  • 2.

  • 3. Upload Insurance Medical Card or Food Stamp Card: 

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  • 4. HOUSEHOLD MEMBERS AND ANNUAL INCOME:

    If you have documents from box 2 skip Part 4 and go to Part 5. Complete Part 4 only if using Federal Income Tax return.
  • 5. SIGNATURE: I certify that I am the parent/guardian of the child for whom this application is made and that all of the above information is true and correct. I also certify that the food stamp or other eligible program case number is current, correct, or that all income is reported. I understand that institution officials may verify the information and documents provided.

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  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • 6. RACE

  • INSTRUCTIONS FOR SCHOLARSHIP ELIGIBILITY APPLICATION

  • Scholarships are based on the income or documentation guidelines below

     

    2023 Income Guidelines for scholarship rate

    Household Size Annual Monthly Twice Per Month Every 2 Weeks  Weekly
     1  23,606  1,968  984  908  454
     2  31,894  2,658  1,329  1,227  614
     3  40,182  3,349  1,675  1,546  773
     4  48,470  4,040  2,020  1,865  933
     5  56,758   4,730  2,365  2,183  1,092
     6  65,046  5,421  2,711  2,502  1,251
     7  73,334   6,112  3,056   2,821  1,411
    For each additional member add:  $8,288  $691  $346  $319 $160
  • Food Stamp/ K – TAP/Medical Card – If you receive any of this type of assistance please complete the form as instructed and provide the agency with a copy of the document for each child.

    Foster Child/Military Verification – Please provide verification of Foster Child status or Military Service verification card to qualify.

    All Other Households – If your household income is at or below the amount shown for the size of your household, please fill out the application completely. You will be asked for the following information and must provide a copy of your Federal Income Tax return for the current or prior year. (Please redact/black-out your social security number from your tax return document.)

    Household Members – List the names of everyone who lives in your household, Include parents, grandparents, all children, other relatives, and unrelated people who live in your household.

    Annual Income – List the total income your household receives annually. Also list the income amount (before deductions for taxes, social security, etc.) each person received last annually and where it came from (wages, retirement, welfare, etc.) If you have a household member whose annual income was higher or lower than usual, list that person’s expected average annual income.

    Signature – An adult household member must sign the application.

    Verification – The information you put on the application may be checked by agency officials at any time during the year.

    Reporting Changes – If your situation changes at any time during the year, please contact the agency.

    Nondiscrimination –No child shall be discriminated against because of race, sex, color, national origin, religion, age, or disability.

    Confidentiality – The information you provide will be treated confidentially and will be used only for eligibility determinations and verification of data.

  • Sport Scholarship Agreement & Application 2023

  • This Scholarship participation Agreement (“Agreement”) made and effective on   Pick a Date   , by and between the following individuals:

    1. Lexington Fayette Urban County Government

    2.      
    (Organization listed in #2, above will represent “Your Organization” in the sections below)

    Lexington Fayette Urban County Government and Your Organization set forth in this written Agreement, the terms and conditions by which they will be governed in this Agreement.

    Therefore, in consideration of the promises contained in this Agreement, Lexington Fayette Urban County Government and Your Organization affirm in writing their association as a simple agreement in accordance with the following provisions:

    1. Purpose.
    The purpose of the Agreement shall be to create, encourage and allow access to Lexington, Kentucky youth who otherwise may not have the financial means or opportunity to participate in youth sports. Financial assistance through the Program is therefore available to assist those players who are not able to afford the total costs associated with playing sports.

    2. Term.
    Both organizations listed in #1 and #2 above shall commence as of the date of this Agreement and shall continue until terminated as provided herein or the “Season End Date” listed in section 8.

    3. Books and Records of Account.
    The Scholarship Agreement books and records shall be maintained by the Athletics Recreation Manager at Lexington Fayette Urban County Government. Your Organization shall have access to the books and records at all reasonable times. The Books and Records of Account will consist of: Organization name, address, telephone number, main point of contact, per transaction scholarship amount paid from Lexington Fayette Urban County Government to Your Organization, scholarship participant name, scholarship participant scholarship amount per transaction.

    4. No Individual Authority.
    Neither organization, acting alone, shall have any authority to act for, or to undertake or assume any obligation, debt, duty or responsibility on behalf of another as expressly provided in this Agreement.

    5. No Responsibility for Other’s Commitments.
    Lexington Fayette Urban County Government and Your Organization shall not be responsible or liable for any personal indebtedness or obligation of any each other incurred either before or after the execution of this Agreement. Lexington Fayette Urban County Government nor Your Organization shall be responsible or liable for any personal indebtedness or obligation of each other incurred either before or after the execution of this Agreement.

    6. No Restrictions on Other Activities.
    Nothing in this Agreement shall be construed to restrict Lexington Fayette Urban County Government nor Your Organization from engaging in any business activity, even if such activity is competitive with the business in this Agreement.

    7. Events of Dissolution.
    The Agreement shall be dissolved upon the sole or mutual agreement of the Lexington Fayette Urban County Government or Your Organization to dissolve the Agreement or by the ending of the term.

    8. Organization Information.

  • Format: (000) 000-0000.
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  • PARENT/ GUARDIAN RELEASE INFORMATION

    1. I/We, the parent/guardian of the above named candidate for a position on the Lexington Ravens Youth Travel league, hereby give approval for him/her to participate in any and all football activities.
    2. I/We are aware that participation in football may result in serious injuries, and protective equipment does not protect against all injuries to participants and I do hereby waive, release, absolve, indemnify, and agree to hold harmless the Lexington Ravens Youth Travel League, the organizers, sponsors, coaches, participants and person transporting my/our child weather the result of negligence or any other cause. I/We grant permission for my child to receive emergency treatment whenever necessary while participating in Lexington Ravens Youth Travel League. I/We understand that in an emergency, whenever possible, an attempt will be made to notify his/her legal guardian.
    3. I/We accept full responsibility for any equipment that my/our child is allowed to use, and will pay to receive any and all equipment lost or destroyed except through normal wear and tear. I/We will not alter the equipment in any way as to render the manufacturer's warranties null and void. I/We will return the equipemt washed and cleaned promptly at the end of the season as requested by the team.
    4. I/We agree to allow the Lexington Ravens Youth Travel League to release photographs of my child for publicity in newspapers and on our web site. Individual children will not be identified in photos.
  • Altercation Policy

  • Lexington Ravens Youth Travel League
    556 North Broadway Lexington, Ky 40508

     

    PURPOSE

    To promote the ideals of teamwork, sportsmanship and acceptable social behavior at LRYTL events/ activities.

    SCOPE
    It is the goal of LRYTL to provide an environment where our participants can grow, not only physically, but also mentally. It is the responsibility of our leaders, participants and fans/spectators to provide an example of self-control and integrity in the hopes that others follow their example.

    POLICY
    Leaders:
    A leader is an individual who holds any supervisory position, including but not limited to, coaches, assistant coaches, program officials, program supervisors and program volunteers.

    Participants:
    A participant is an individual, other than a leader or a fan/spectator, who takes an active part in events/activities that LRYTL sponsors.

    Fans/Spectators:
    A fan/spectator is an individual who participates in LRYTL events/activities by demonstrating support without taking a leadership or participant role in that particular event.

    1. Fighting:
    A hostile encounter with another party or parties, resulting in a physical struggle or contact, will be defined as a "fight." Fighting will not be tolerated on the part of any participant or spectator associated with LRYTL events/activities.

    A. Leaders
    First Offense - Lifetime suspension as a leader or participant in LRYTL activities/events from the date of incident. One (1) year suspension as a fan in LRYTL events/activities from the date of incident.

    B. Participants
    First Offense - (Adults: 18 & Over) Lifetime suspension as a leader or participant in LRYTL events/activities. One (1) year suspension as a fan in LRYTL events/activities from the date of incident. 

    First Offense - {Youth: 17 & Under) One (1) year suspension as a leader, participant and/or fan spectator from LRYTL events/activities from the date of incident.

    Second Offense - {Youth: 17 & Under) Suspension as a leader, participant and/or fan/spectator from all LRYTL events/activities until the age of eighteen (18) or for one (1) year, whichever is greater.

    C. Fans/Spectators
    First Offense - One (1) year suspension as a fan/spectator and participant from LRYTL events/activities from the date of the incident. Lifetime prohibition from a leadership role in 
    LRYTL events/activities.

    Second Offense - Lifetime suspension as a fan/sponsor, participant and leader from all related LRYTL events/activities from the date of incident.

     

    2. Unsportsmanlike Conduct
    LRYTL strives to create an environment that teaches individuals the art of good sportsmanship. Unsportsmanlike conduct includes but is not limited to:

    Verbal abuse defined as the intentional act of insulting another individual through oral measures with the aim of offending.

    Use of Racial and/or Gender Epithets defined as the use of racial and/or gender epithets used in reference to an individual's race, ethnicity, color, gender, gender identity or sexual orientation.

    Inappropriate behavior defined as the use of obscene or inappropriate gestures or sounds.

    Bullying defined as a persistent pattern of mistreatment that causes harm or humiliation used in reference to an individual's race, ethnicity, color, religion, age, sex, disability, gender identity or sexual orientation.

    A. Leaders and/or Participants - (Adults: 18 & Over)
    First Offense - One (1) year suspension as a leader, participant or fan/spectator from LRYTL events/activities from the date of the incident.

    Second Offense - Lifetime suspension as a leader and/or participant from LRYTL events/ activities. One (1) year suspension as a fan in LRYTL events/activities from date of incident.

    B. Leaders and/or Participants - (Youth: 17 & Under)
    First Offense - Immediate suspension as a leader, participant and/or fan/spectator from event/ activity and suspension from next scheduled program event/activity.

    Second Offense - One (1) year suspension as a leader, participant and/or fan/spectator from LRYTL events/activities from the date of incident of the second offense.

    Third Offense -Three (3) year suspension as a leader and/or participant from LRYTL. One (1) year suspension as a fan in LRYTL events/activities from date of incident.

     

    3. Procedures Following Incident

    When a person engages in unsportsmanlike behavior within the LRYTL events/activities, recreation supervisors, recreation leaders, league supervisors and/or league officials will:

    1. Have the individuals involved in the dispute escorted from the park or facility at which the event is occurring. During such time, the sporting event or program will be stopped until those involved have left the park or facility property. If a person(s) refuses to leave the premises, the LFUCG Division of Police will be contacted and asked to enforce the ruling of the officials.
    2. Individuals removed from the park or facility will be sent a notification letter stating their violation of the altercation policy. The individual will then have seven (7) days from the receipt date of the registered mailed letter to respond with a written statement, explaining or defending their involvement and setting out their perception of the altercation as it occurred.
    3. The response must be received by the office of the Division of Parks and Recreation Program Manager of the event/activity at the address provided in the notification letter on or before the seventh day from the receipt date of the registered mailed letter. No written statement will be considered in the investigation after the seven (7) days.
    4. After the statements are received, an investigation will be conducted and Lexington Parks and Recreation will render judgment of the altercation within ten (10) working days from the statement deadline.
    5. A panel consisting of the division director/director's designee, program manager and the program supervisor of that particular program in which the altercation occurred will conduct the investigation.
    6. During this investigation, the individual(s) accused will be suspended from all events/activities.
    7. Those found in violation of this policy, or who are not content with the panel's decision, may file an appeal to the office of the director of LFUCG Division of Parks and Recreation, 469 Parkway Drive, Lexington, Kentucky 40504. In filing an appeal, an individual(s) will have five (5) business days to respond in writing from notification of the decision, and said appeal shall be received in the director's office on or before, the fifth day after notification of the decision. Individuals may be asked to appear before the appeal review committee.
    8. All appeal decisions are final and are not subject to review. If Lexington Parks and Recreation deems a physical or verbal altercation as a flagrant and deliberate act of violence, the division reserves the right to enforce a more severe punishment within this established disciplinary code.
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