Funding Application – sportassist.ca

1 Applicant Information

Applicant / Child Name*

Date of Birth*

2 Parent / Guardian Information

Full Name*

Email*

Phone*

Address*

3 Activity Information

What is the Activity?*

Club / League / School*

Activity Contact Person*

Activity Contact Phone*

Activity Home Facility Address*

Time Participating in This Activity*

Time With Current Club / League / School*

Activity Start Date*

Activity End Date*

4 Funding Details

Cost of Full Registration*

Amount Requested*

Name to Make Cheque Payable To(Optional)

Other Organization Helping Fund This Applicant*

5 Reference Information

Your reference must be a professional third party familiar with your family — not a friend, family member, coach, registrar, or club director. See the full list of accepted references on the Funding page.

Reference Name*

Reference Phone Number*

Reference Email*

Reference Organization & Title*

Relationship of Reference to Applicant*

Anything Else You'd Like Us to Know? (Optional)

I understand that approved funding is paid directly to the sport organization, cannot cover deposits or travel, and that I must notify SportAssist if my child withdraws or receives funding from another source.