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Welcome to Loadus LED360 Sports League
Team Loadus
20
Questions
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1
Name Of The Parent
First Name
Last Name
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2
Name of Athlete or Ambassador
First Name
Last Name
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3
Child's Date Of Birth
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Date
Year
Month
Day
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4
Child's Gender
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5
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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6
E-mail
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7
Phone Number
Area Code
Phone Number
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8
Qualification Documentation
Medicaid, SNAP or WIC cards will NOT be approved. Supported file formats are gif, jpg, png, pdf, heif, and jpeg.
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9
Additional Qualifying Document
If you need to upload another file to complete your documentation, please upload it here.
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10
Are you or your sponsor/guardian able to volunteer at our stadium events?
YES
NO
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11
Sport Or Activity Grant Will Be Used For*
BadMinton
Baseball
Boxing
Basketball
Cross Country
Cheer Leading
Dance
Fencing
Field Hockey
Flag Football
Football(American)
Gym
Golf
Hockey
Lacrosse
Martial Arts
Mountain Biking
Skating
Skiing/Snowboarding
Soccer(Futbol)
Softball
Swimming
Tennis
Track & Field
Volleyball
Water Polo
BadMinton
Baseball
Boxing
Basketball
Cross Country
Cheer Leading
Dance
Fencing
Field Hockey
Flag Football
Football(American)
Gym
Golf
Hockey
Lacrosse
Martial Arts
Mountain Biking
Skating
Skiing/Snowboarding
Soccer(Futbol)
Softball
Swimming
Tennis
Track & Field
Volleyball
Water Polo
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12
Season Start Date
Provide an estimate on when the season will begin.
-
Date
Year
Month
Day
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13
Season End Date
Provide an estimate on when the season will end.
-
Date
Year
Month
Day
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14
Hours Of Participation Per Week*
Please Enter a number from 0 to 40. Only enter a numerical value, do not enter words or symbols.
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15
What's the Name Of The Organization Hosting Your Sport?
Either Loadus LED 360 or list the name of the park, Rec, school, YMCA, etc.
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16
Who referred you?
(Loadus LED 360 Sports League)
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17
Cost Of Registration
Please enter a number greater than or equal to 1. What is the total registration fee if you were to register your child for this program without the Every Kid Sports Pass?
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18
Grant Request Amount($150 Max)
Please enter a number from 1 to 150. Please enter a number less than or equal to 150. Do not input a number that exceeds the registration cost.
Please enter a number from 1 to 150. Please enter a number less than or equal to 150. Do not input a number that exceeds the registration cost.
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19
My Products
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My Bag
1
My Bag
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Great Product Name
$20
Quantity:
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Great Product Name
$20
Quantity:
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Size:
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
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ORDER SUMMARY
Total cost
USD
Processing Fee
The processing fee is per child.
$
20.00
+
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20
Terms and Conditions
*
This field is required.
1.) Each household is permitted one Chek account. (2.) Households with multiple children will receive all approved funds in the same Chek account. (3.) The LED 360 Loadus Sports Pass approved funds will only be permitted to assist payment towards the registration fees with the youth sports organization listed on the approved application. (4.) Attempts to use the LED 360 Loadus Sports funds for an establishment other than the youth sports organization listed in your application will result in a decline at the point of sale and funds being automatically retracted. (5.) Attempts to submit falsified Medicaid, SNAP, WIC, or other supporting documents to qualify a child will result in a declined application and will forfeit future use of the LED 360 Loadus Sports Pass. If required by State Law, LED 360 Loadus will file a claim for fraudulent use of Medicaid, SNAP, WIC, or other falsified documents in your application. (6.) LED 360 Loadus Sports reserves the right to remit funds, retract funds, and/or decline all future applications if the applicant provides documents that appear fraudulent or falsified in order to receive funding from the LED 360 Loadus Sports Pass. (7.) LED 360 Loadus Sports reserves the right to remit funds, retract funds, and/or decline all future applications if the LED 360 Loadus Sports Pass funds are attempted to be used for an establishment other than the specified youth sports organization in your application (8.) LED 360 Loadus reserves the right to terminate and retract or remit the approved LED 360 Loadus Sports Funds for any fraudulent behavior or activity (9.) If funds are not used within 60 days of your approval date, your approved funds will automatically be remitted to LED 360 Loadus Sports (10.) The parent/guardian is required to cover at least $10 towards the youth sports registration fees. If you are not approved for the full $150 it is because the youth sports organization's registration fees are less than $160 (11.) LED 360 Loadus Sports reserves the right to award only the amount which is verified by the youth sports provider as the registration fees, per child, with a sibling, low-income, or other discounts made available to the family. (12.) Only parents and/or legal guardian(s) of the child, listed in the application, are permitted to apply for the LED 360 Loadus Sports Pass. (13.) Leagues, Teams, Advocates, Coaches, Friends, or any other person who is not the parent or league guardian of the child is not permitted to apply for the LED 360 Loadus Sports Pass. (14.) Parents and/or legal guardians are eligible to reapply for the LED 360 Loadus Pass every 90 days per child. Your application will be declined if you attempt to apply within 90 days of your last approved applicaiton (15.) Applications that do not provide adequate qualifying documentation for the child listed in the application will be declined. Adequate documentation includes SNAP, WIC, or Medicaid documentation that provides the following details: the child's name listed in the application and dates within the last 12 months that show the child is actively enrolled. (16.) LED 360 Loadus Sports Pass only provides funding for future recreational sports, leagues, and teams. The LED 360 Loadus Sports Pass funds cannot be paid out for previously paid fees, reimbursements, late fees, or any other use than indicated in the LED 360 Loadus Sports Pass application. (17.) LED 360 Loadus Sports Pass funds cannot be used for personal money transferring applications and use. Examples include but are not limited to Cash App, Venmo, Zelle, and Xoom.
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