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Accessibility Commitment
KidSport Ontario Grant Application Form
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KidSport Grant Application
Image
Section 1: Child Information
Name
First name:
Last name:
Address
Address:
City/Town:
Postal code:
Telephone:
Email:
Gender:
Male
Female
Birth date - 18 and under:
Section 2: Parent / Guardian
Name
First name:
Last name:
Address
Address:
City/Town:
Postal code:
Relationship to child:
How many adults in home:
How many children in home:
How did you find out about KidSport:
FunZone
Sport Organization
Website
School
Recreation Centre
Media
I agree that all above information is accurate.
I agree that all above information is accurate.
Signature:
Sign above
Date:
Section 3: Funding Request
Sport:
Organization / club / league:
Address
Address:
City/Town:
Postal code:
Telephone:
Contact name:
What type of grant:
Registration
Equipment
Both
Sport activity starts:
Sport activity ends:
Amount requested (total not to exceed $250 unless applying for hockey which is $500 max per child):
Amount Requested
Item
Amount
Registration Fee
row1
$
Equipment
row2
$
Total Request
row3
$
Important (registration)
: for registration requests, please attach sport club registration form to verify registration fee.
Important (equipment)
: For equipment requests, , please attach quote for equipment from retailer.
Add an attachment
Maximum 5 files.
10 MB limit.
Allowed types: pdf, doc, docx, jpeg, jpg, png.
Section 4: Income Verification
Gross annual household income (check one):
Less than $15,000
$15,000 - $19,999
$20,000 - $29,999
$30,000 - $39,999
$40,000 and over
Include for each adult in home:
1. Government documentation: Notice of Assessment
AND
2. Current proof of income (check one):
3 consecutive pay stubs
Ontario Works or EI documents
Due to security reasons, we will not accept attachments that may contain sensitive information.
Please visit the Township of North Dundas at 636 St. Lawrence Street to drop off your proof of income documents.
Section 5: Endorsement Section
The Endorser acts as an objective third party who is familiar with the family and is in a professional position to assess the barriers facing the family. (Note: an endorser cannot be an adult sponsor or family member.)
Important:
An endorsement letter needs to be included on letterhead with contact information outlining the barriers the family is facing. A follow-up call to the endorser may be required.
Add an attachment
Maximum 5 files.
10 MB limit.
Allowed types: pdf, doc, docx, jpeg, jpg, png.
The endorser must be one of the following (check one):
Professional in family services or social work
Teacher
Principal
Member of clergy
Family Doctor
Police Officer
Lawyer
Accountant
Employer