Support Request Form

Support Request Form

Please fill out this form to request a gear donation from our organization.
*Submitting more than one request does NOT increase your chances of being selected. Please submit only one request.*
Please Note:

We receive far more requests than we can fulfill. Our team reviews each submission carefully, and priority is determined based on need, impact, and available resources.
Does this request come from an individual or an organization?*

OrganizationSchool (K-12)Youth ProgramCoachParentIndividualOther
Organization name*
If not applicable put N/A.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact name*

First NameLast Name
Role/Title (for schools: teacher, coach, principal, athletic director, etc.)*
Individual applicants can put N/A.
Contact email*
Please ensure accuracy
Contact phone number*
Please ensure accuracy
Who is the request for?*

One childMultiple childrenA full teamA school/programOther
How many people will benefit from this donation?*
Type of support needed:*

Individual Equipment SupportTeam Equipment SupportSchool/Program Equipment SupportOther (small requests only)
Please provide further details on this request.*
Please provide a brief summary of what you are requesting and how it will help.
Why support is needed?*
Please share any information that helps us understand the need for support.
Is there a deadline?*

YesNo
Date

MonthDayYear
If you selected "Yes" above please enter the deadline date.
How did you hear about us?*
Please verify that you are human*
I agree to be contacted by Back in Play regarding this request. I understand my request is not guaranteed and that I will only be contacted upon acceptance.*

I understand
Should be Empty:

Support Request Form

*Submitting more than one request does NOT increase your chances of being selected. Please submit only one request.*

Please Note:

Submitting more than one request does NOT increase your chances of being selected. Please submit only one request.