Sport Start Parent/Carer Application Form

SPORT START PARENT/CARER APPLICATION FORM
T's & C's
- Tamariki (ages 5 to 12 years) are entitled to up to $60 per calendar year
- Rangatahi (ages 13 to 18 years) are entitled to up to $100 per calendar year
- Age is relative to the date of application
- You MUST have a CURRENT Community Service Card, either in the Parent/Carer's name or the Child's name
- If your second choice of sport is with a different organisation/provider you must completed a separate application with that Registered Provider
- You may apply as many times per year as you like, until you reach your funding limit
- Funding rounds are processed and paid out monthly, on/around the 20th (excludes January)
- Applications must be submitted by the 10th of the month for payout to be made that month
- When approved, funds are paid directly to the Registered Provider School/Club/Organisation (any difference between fees and funding is NOT covered by Sport Tasman)
- Funding MUST be used for sport subscriptions only: for example it cannot be used for travel or uniforms
CHILD'S DETAILS

First NameMiddle NameLast Name
DATE OF BIRTH

MonthDayYear
Date
WHO DO I PAY FOR MY SPORTS?

eg my school, club, other organisation (the Registered Provider). If sports are with different providers, you must use a separate application for each provider
FIRST SPORT OF CHOICE
If your Sport of Choice is not listed here, let us know so that we can add it.
Season Start Date (Sport 1)

MonthDayYear
Date
Season End Date (Sport 1)

MonthDayYear
Date
Amount applied for (Sport 1)
SECOND SPORT OF CHOICE - If this is with a different provider - you must submit a separate application
If your Sport of Choice is not listed here, let us know so that we can add it.
Season Start Date (Sport 2)

MonthDayYear
Date
Season End Date (Sport 2)

MonthDayYear
Date
Amount applied for (Sport 2)
REGISTERED PROVIDER DETAILS

You should select the name of the school/club/organisation that YOU PAY for the sport. If your organisation is not listed here, please contact Sport Tasman. (It's an easy process to register as a Sport Start provider - you can get them to register online at www.sporttasman.org.nz)
Nelson/Tasman based
Marlborough based
Buller/Kaikoura based
Name of Liaison Person at that organisation
Contact Number of Liaison Person at that organisation

Area CodePhone Number
PARENT/CARER

First NameLast Name
RELATIONSHIP TO CHILD
Email Address
example@example.com
Contact Number

Area CodePhone Number
*If, as Carer, you are completing this form 'on behalf of' a family, please confirm permission to sign on their behalf by ticking the box below
UPLOAD A COPY OF YOUR COMMUNITY SERVICES CARD

Community Services Card MUST be current at the time of submission. Please upload a photo of the front of the card ensuring the 11 numbers above your name are clearly visible. If you do not have access to the physical card, an upload of a screenshot from your WINZ account showing card number and expiry date is acceptable. A card in the name of the Carer or Child is also acceptable.
COMMUNITY SERVICES CARD NUMBER (the 11-digit number ABOVE your name)
Please enter a valid number.Format: 0000-0000-000.
Upload

Cancelof
Electronic Signature of parent/guardian (or the liaison person) from the appropriate organisation)
Should be Empty:

SPORT START PARENT/CARER APPLICATION FORM

WHO DO I PAY FOR MY SPORTS?

UPLOAD A COPY OF YOUR COMMUNITY SERVICES CARD