Confidential Financial Assistance Application

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SRYBA has limited funds available for situations involving financial hardship, and applications will be considered on a first come, first serve basis. To be considered for SRYBA financial assistance, an application form must be submitted along with a detailed explanation for seeking assistance. All financial assistance awarded will be confidential, and all personal information will be kept confidential.

If approved by SRYBA Board, a player may receive a discounted registration fee.

Parent Name(s): *

Your email address: *

Telephone Number: *

Home Address: *

Player Name(s): *

Player(s) Birthday (__/__/____) and current grade in school: *

Program you are seeking financial assistance for: *

CMCBL ($175 registration fee)

Coach Pitch ($50 registration fee)

T-Ball ($50 registration fee)

Other:

Amount of aid requested: *

Reason For Request:

Please provide details of why you are requesting this aid.

I acknowledge that the information contained on this application is accurate and correct. I hereby give permission to SRYBA to verify this information. I understand that if any information on this application is found incorrect, my privilege of applying to financial assistance may be revoked.
*

Yes

Required

I understand that Parents of players who receive financial assistance will be asked to commit to volunteer time to SRYBA to demonstrate their support of the program.
*

Yes

Required

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