2023-2024 KC Fusion Premier Scholarship Application

The KC Fusion scholarship program exists so that children are not prevented from playing soccer for our club because of financial reasons. As a 501(c)(3) organization, we are limited to strict budgetary guidelines. However, we will carefully consider all applications for scholarship.

Scholarship Deadline
All applications must be submitted online for the KC Fusion premier program at or before TRYOUT CHECK-IN.

Review the instructions carefully. Submission of an application does not constitute approval. Applications must be completed each soccer year and prior to tryouts for Fusion. You will be notified of your scholarship status via email once the application has been processed and approved.


Please read this form in its entirety and complete all information in this application.

FILING INSTRUCTIONS AND INFORMATION:

  • Fill out the application accurately and completely. Partial applications will not be accepted.

  • You may be asked to provide a copy of your latest Federal and/or State Income Tax Return for verification of income.

  • If eligible for free and reduced lunch, Medicaid or medical assistance, food stamps, subsidized housing or you have been previously approved for scholarship or financial aid from a private/parochial school please attach documentation for validation.

  • You will still be responsible for payment of any personal travel expenses when attending out of town events.

  • This scholarship may be full or partial depending on the level of need for the season, as well as your individual circumstances. The initial amounts awarded are $250/player for U8-U14 and $150/player for HS. Additional monies may be awarded, but not guaranteed.

  • The Club Bookkeeper, Treasurer, and Administrative Staff will be made aware of your financial arrangement with the club. We will protect your privacy as carefully as possible.


Sign in to Google to save your progress. Learn more
Email *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Address *
City,State, Zip Code *
Phone *
2nd Phone
Email Address *
2nd Email Address
List all children in the household who will be considered for this scholarship.   *
Child 1 First Name
Child 1 Last Name *
Child 1 - Birth Year *
Child 1 - Gender *
Child 1 Date of Birth *
MM
/
DD
/
YYYY
Child 2 First Name
Child 2 Last Name
Child 2 - Birth Year
Child 2 - Gender
Child 2 Date of Birth
MM
/
DD
/
YYYY
Child 3 First Name
Child 3 Last Name
Child 3 - Birth Year
Child 3 - Gender
Child 3 Date of Birth
MM
/
DD
/
YYYY
Child 4 First Name
Child 4 Last Name
Child 4 - Birth Year
Child 4 - Gender
Child 4 Date of Birth
MM
/
DD
/
YYYY
Check total gross income earned by all adults in your household for the year: *
Check any assistance the household currently receives (check all that apply): *
Required
How many individuals are supported by your household income? *
Adults
*
Children
1) Explain your financial situation: 2) Describe how you volunteered for the CLUB in the last season. 3) Describe how you will volunteer for the CLUB in the next season. *
Please submit a brief explanation of your financial situation.  Special circumstances such as large medical expenses not covered by insurance, loss of income due to illness or unemployment, etc. are taken into consideration, so be sure to include this information in your written explanation.
By electronically signing this application, I agree that all information provided is true to the best of my knowledge and give KC Fusion permission to verify its accuracy. I understand KC Fusion will assess my situation based upon the current ability to provide assistance. I agree to donate volunteer work time to the KC Fusion if a scholarship is granted by assisting with administrative duties, team management duties, or tournament assistance as needed. *
Name
*
Date
PARENTS APPROVAL AND MEDICAL RELEASE In consideration for being allowed to participate in any way in the USSF sanctioned play, including play sanction by the US Youth Soccer Association and the Kansas State Youth Soccer Association, as a player in games, training activities and exercises, and related events and activities, the undersigned: 1. Agree that the parent(s) and or legal guardian(s) together with their minor participant will, prior to participating, inspect the facilities and equipment to be used, and if they or the participant believe anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition(s) and refuse to participate. 2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inaction or negligence, but the action, inaction or negligence of others, the rules of play, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. 3. Assume all foregoing risk and accept personal responsibility for damages following such injury, permanent disability or death. 4. Release, waive, discharge and covenant not to sue US YOUTH SOCCER ASSOCIATION, KANSAS STATE YOUTH SOCCER ASSOCIATION, their affiliated clubs, their respective administrators, directors, agents, coaches and other employees of the organizations, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event, all of which are hereinafter referred to as "releases," from any and all LIABILITY to the participant and the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death or damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise. 5. CONSENT FOR MEDICAL TREATMENT (MINOR) As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent. I/WE HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT WE HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY. The Information above and medical history supplied is correct to the best of my knowledge. *
Required
Electronic Signature *
Date *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of KC Fusion.

Does this form look suspicious? Report