Financial Aid Application for Youth Sports Leagues and Groups

(for Middletown Residents Only)

Child’s Name:_______________________________________________________________________

Child’s Address:_____________________________________________________________________

School Attending:____________________________________________________________________

Child’s Birthdate:____________________________________________________________________

Parent/Guardian Name:_______________________________________________________________

Parent/Guardian Phone 1: _____________________________Phone 2:________________________

Sport or Organization:________________________________________________________________

I understand that in order to be considered for financial aid I must provide one of the following:

1.  State Of Connecticut Budget Sheet that states the family is on Temporary Aid to Needy Families receiving cash assistance
2. Form from the Board of Education stating that the child is on the FREE Lunch Program
3. A letter from a school Social Worker or Principal stating the family cannot afford the registration fee

Parent/Guardian Signature:______________________________________Date:____/______/_____

Please understand that funding is very limited and the League Presidents and/or Board members will make the decisions as to who receives financial aid and how much a participant’s fees will be discounted.