Individual Grant - Gold Rush Senior Hockey Tournament

- Step 1 of 3

Step 1 of 3

Grant Number

GRSH Individual Youth grant application for youth hockey and figure skating

What type of assistance are you applying for? *

Equipment (e.g., skates, hockey sticks, helmets, gloves, protective gear, practice jerseys, figure skates, or costumes)
League Fees (e.g., registration fees, team dues, tournament entry costs, travel expenses for competitions)

Parent or Guardian Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Annual Household Income *

Number of People in Household *

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Step 2 of 3

Athlete Information

Athlete Name *

First

Last

Athlete Age *

Athlete Grade *

Sport *

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Step 3 of 3

Sports Program Organization:

Select the program you’re requesting funding for: *

Sport Program Organization Contact Name *

First

Last

Sport Program Organization Phone *

Sport Program Organization Email *

Total Program or Equipment Cost (USD) *

Enter the amount (e.g., $275 for Learn to Play package).

Minimum Price: $100.00

Season Start Date: *

Season End Date: *

Total Length of Program (weeks) *

Please Tell Us About Yourself and Why You're Requesting This Grant: *

This section must be completed by the youth requesting assistance. In your own words, tell us a little about yourself—your interests, goals, and what participating in this activity means to you. Please also explain why you are requesting this grant and how it will help you take part. We want to hear your story in your voice.

Registration Due Date *

Disclaimer *

Yes, I understand and accept the terms

I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that providing false information may result in the rejection of my application. I authorize Gold Rush Senior Hockey to verify the information provided.

Parent/Guardian Signature (if applicant is under 18 years old): *

Clear Signature

Date *

Upload Verification Document (Optional)

Drag & Drop Files, Choose Files to Upload

Attach Skatetown invoice, program screenshot, or registration email (PDF or image).

Coach or Instructor Name (Optional)

If known, provide the name of your coach or instructor.

Approval Status

Grant Approved Amount

Last Status Change

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