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3. 
5. The Phillip D. Penland Tribute Fund was established to cover the participation fees for kids in the community who might not be able to afford to participate in our youth sports programs. All requests must be submitted no later than two weeks prior to the start date of the program in which you are requesting financial assistance. Please allow for up to five business days for a response.
7. Date:*
   Date:
9. I Request:*

   1. Full Financial Assistance
   2. Partial Financial Assistance (Enter amount you can pay in the explanation box below.)
11. Participating Activity:*

    1. Baseball
    2. Softball
    3. Basketball
    4. Flag Football
    5. Cheerleading
12. Age Division:*
13. Has Applicant/Player participated in any of these programs in the past?*

    1. Yes
    2. No
15. Applicant/Player First & Last Name:*
16. Applicant Date of Birth:*
18. Parent/Guardian First & Last Name:*
20. Address:*
22. City:*
23. State:*
24. Zip Code:*
26. Phone:*
27. Email:*
29. Financial Hardship Explanation:*
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field