Clackamas Youth Basketball Classics Finanacial Assistance Application
Financial Assistance: Clackamas Youth Basketball's (CYB) Board of Directors will review all requests and contact the requester. CYB is a non-profit organization with limited funds. However, we do not want any player to be left out of the program due to inability to pay. Although full assistance may not be available, Clackamas Youth Basketball may be able to grant partial relief. It is expected that a family receiving financial assistance will volunteer within the Clackamas Youth Basketball program.

ALL INFORMATION PROVIDED IS CONFIDENTIAL.

Participant Information *
First & Last
Your answer
Address *
Street, City, State & Zip Code
Your answer
Grade or Coach's Last Name *
Your answer
School Attending *
If Private School or Other, please provide the name:
Your answer
Date of Birth
MM
/
DD
/
YYYY
Parent/Guardian 1 *
First & Last Name
Your answer
Parent/Guardian 2
First & Last Name
Your answer
Email *
Your answer
Primary Phone Number *
Your answer
Best Time to Contact *
Time
:
If your address is not the same as your child's, please provide: *
Your answer
Scholarship Applicants: *
Please indicate the amount you are able to contribute to your child's team fee.
Your answer
Scholarship Applicants: *
Will you be able to provide a letter from the school district that your player qualifies for free or reduced lunch?
Your answer
Acknowledgment *
By chicking this box and providing an electronic signature, I acknowledge that all staments herein are true and accurate. Further, I pledge that I will honor any agreed financial commitment.
Required
Electronic Signature *
Your answer
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