Application Form | SportAssist

Page 1 of 3

SportAssist Funding Application

Before completing the following form, please review SportAssist's Application Information.

Step 1 of 3: Activity Information

Club/League/School*

Please include Club/League/School.

Contact Name*

Please include Activity Contact Name.

Contact Position*

Please include Contact's Position.

Address*

Please include activity's address.

Phone*

Please include activity contact's phone number.

Email*

Invalid Input

Sport/Activity for which grant will be used*

Please include Sport/Activity for which grant will be used.

Is this the first time this child will be enrolling in this sport?*

YesNoPlease Select

If no, how many years has child been involved in this sport?

Please include number of years.

Activity Start Date*

Please select date.

Activity End Date*

Please select date.

Full Registration Cost*

Please include Full Registration Cost.

Grant Requested*

Please include Grant Requested.

Make SportAssist Cheque Payable to*

Please include cheque payable information.

Has funding been applied for through any other organization?*

YesNoPlease select.

If yes, please provide organization name and contact information:

Invalid Input

Step 2 of 3: Child & Parent/Guardian Information

Child’s Full Name*

Please include Child’s full name.

Parent or Guardian’s Full Name:*

Please include Parent or Guardian’s Full Name.

Address*

Please include Address.

Phone Number*

Please include phone number.

Email Address*

Please include a valid email address.

Birthdate*

Please include birthdate.

Sex*

FemaleMalePlease select.

Step 3 of 3: Reference Information

The reference must be a third party who is familiar with the child's family and is in a professional position to assess the social and economic barriers of the family and must be available to be contacted if further information is needed.
A reference may be a professional in social work or family services (ex. Nurse, social worker, licensed child care worker), a school principal or guidance counsellor, a senior recreation administrator, a member of the clergy, physician, law enforcement officer, lawyer, accountant, or employer of the parent or guardian. Other references may also be accepted if accompanied by a letter outlining the circumstances of the family; however family members, coaches, registrars or directors of sports clubs are not accepted as references.

Reference Full Name*

Please include Reference's Full Name.

Address*

Please include Reference's Address.

Phone Number*

Please include Reference's Phone Number.

Email Address*

Please include a valid email address.

Relationship to Family*

Please include Reference's Relationship to Family.

Organization

Please include Reference's Organization.

I Agree *I agree with these guidelines (please check box).

I have read and understand the SPORTASSIST Program guidelines and agree that this application meets them. I, the applicant for the child named in step #2, agree that I have discussed this application with the reference, who has agreed to provide information regarding this family and its eligibility for the SPORTASSIST grant, and that a SPORTASSIST representative can contact the reference named in step 3.

Anti-Spam Numbers *

RefreshPlease try numbers again.