NYSA Financial Assistance Request
NYSA's goal is to provide an opportunity for all children in the area to participate in recreational sports.  In order to achieve this goal, NYSA may provide financial assistance to qualifying families.  In order to be considered for financial assistance, this request must be completed and submitted.  If you're requesting assistance for more than one child, a separate form must be submitted for each child.

Please REGISTER NOW for the sport you wish to receive financial assistance from.  If you fail to register, your child may not be eligible to play.
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Email *
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Are you a foster family? *
Full *
Which sport are you requesting financial aid for? *
Which season are you requesting financial aid for? *
Guardian/Parent First and Last Name *
Home Address *
Home Phone *
Work or Cell Phone *
Primary Email Address *
Will you need help providing equipment for your child? *
Please provide us with any details we should know when considering your request. *
Acknowledgement: I acknowledge that if I am approved for financial aid, I will be responsible for paying the $55 family membership fee to the NYSA.  I understand financial aid is for the amount of the registration fee only.  By typing my name below, I agree that this is valid as my signature. *
Household income Per Year *
This is total household income from all sources.  Supporting documentation such as tax returns may be required.
Type first and last name as valid signature *
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