Financial Assistance Request

We understand that the cost of participation may be a concern for some families. To ensure that all children have the opportunity to participate, we offer financial assistance based on need. Please answer the following questions to help us assess your eligibility for financial assistance.

Do you require financial assistance for your child to participate in this program?(Required)

Yes

No

Please briefly describe your need for financial assistance.(Required)

(Optional: provide any relevant information regarding your current financial situation)

What amount can you contribute toward the program fee?(Required)

How many participants would you like to register?(Required)

Includes flag football players, tackle football players and cheerleaders.

Participant #1 Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

2025-2026 School Grade(Required)

What 2025-2026 School Grade and Sport is the participating registering for?(Required)

Birthdate(Required)

Shirt Size(Required)

Participant #1 Insurance Information

If you have insurance, please list below. The league's insurance is a secondary policy.

Name of Insurance Company(Required)

Policy Number(Required)

Please list any allergies or medication needed:

Participant #2 Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

2025-2026 School Grade(Required)

What 2025-2026 School Grade and Sport is the participating registering for?(Required)

Birthdate(Required)

Shirt Size(Required)

Participant #2 Insurance Information

If you have insurance, please list below. The league's insurance is a secondary policy.

Name of Insurance Company(Required)

Policy Number(Required)

Please list any allergies or medication needed:

Participant #3 Information

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

2025-2026 School Grade(Required)

What 2025-2026 School Grade and Sport is the participating registering for?(Required)

Birthdate(Required)

Shirt Size(Required)

Participant #3 Insurance Information

If you have insurance, please list below. The league's insurance is a secondary policy.

Name of Insurance Company(Required)

Policy Number(Required)

Please list any allergies or medication needed:

Parent / Guardian Information & Consent

Parent / Guardian Name(Required)

First Last

Email(Required)

Mobile Phone(Required)

Emergency Phone(Required)

Payment Information

Total

Credit Card(Required)

Cardholder Name

Card Details