EKS Pass Application – La Pine

The child is between 4 - 18 years of age(Required)

Yes

No

The athlete/child must be between the ages of 4 - 18 years at the start of the sports season to qualify for the Every Kid Sports Pass.

Please visit this article in our Help Center(https://help.everykidsports.org) for more information.

My child is enrolled in Medicaid, WIC, or SNAP and I have the enrollment letter/document which states my child's benefits are active(Required)

Must Include: Child's name AND date of active benefits, within 12 months. Active benefit dates must be within one year of today's date. Medicaid, SNAP, or WIC Cards will automatically decline

Yes

No

The athlete/child must prove current enrollment in Medicaid, WIC, or SNAP to qualify for the Every Kid Sports Pass. Please feel free to re-apply when you locate your ACTIVE benefit document.

Please visit our Help Center (https://help.everykidsports.org) for examples of valid qualifying documents.

I am requesting funds to support my child's participation in recreational youth sports(Required)

Registration fees cannot exceed $500 for 3 months of participation to be considered for the Every Kid Sports pass

Yes

No

The Every Kid Sports Pass is not available for programs that exceed $500 for 3 months or less of participation.

Please visit our Help Center (https://help.everykidsports.org) for information on our program requirements.

I understand that exiting the application for any reason before submitting may result in losing my placeholder to apply today.(Required)

Yes

Child Information

In this section, you will be providing information on the child who will be registering for the sport.

Child's Name(Required)

Child's First Name Child's Last Name

Child's Date of Birth(Required)

Child's Age

Please check the birthdate you entered for the child. The age of this child is outside of the range for this program.

Child's Gender(Required)

How would you best describe the child you are applying for?(Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Multiracial or Biracial

Native Hawaiian or Other Pacific Islander

White

Prefer not to answer

Other

What language is usually spoken at home?(Required)

This question will only be used for research purposes and is not part of the application or a commitment to provide translation.

Qualification Documentation Upload

Only active Medicaid, SNAP, or WIC documents specifically for your child will be considered for approval. Before you upload your document or photo check that it shows dates and your child's name.

Athlete/Child's Medicaid, SNAP, or WIC document(Required)

Insurance, SNAP, or WIC cards will automatically decline.

Accepted file types: gif, jpg, png, pdf, jpeg, heif, heic, Max. file size: 5 MB.

Do you need to upload additional documentation?(Required)

Yes, I have another page to upload

No

Additional Qualifying Document

If you need to upload another file to complete your documentation, please upload it here. Medicaid, SNAP or WIC cards will NOT be approved. Supported file formats are gif, jpg, png, pdf, heif, heic and jpeg. Max file size is 5 MB.

Accepted file types: gif, jpg, png, pdf, heif, jpeg, heic, Max. file size: 5 MB.

Document Authenticity Verification(Required)

I certify that the document I have submitted is the document I received from the government. It is accurate and has not been modified, altered or falsified in any way.

I certify

All uploaded applications will be reviewed for accuracy and authenticity. Any document found to be altered in any fashion will be rejected and, in certain cases, referred to the proper authorities for prosecution.

Is this document a physical card?(Required)

Yes

No

Every Kid Sports does not accept physical cards as a qualifying document. For examples on qualifying documents, visit our Help Center: https://help.everykidsports.org/hc/en-us/articles/6268376811283-What-are-examples-of-qualifying-documents

Acknowledgement(Required)

If this application is declined due to providing insufficient documentation of enrollment in either WIC, SNAP or MEDICAID and I resubmit a new application, the new application will go to the end of the queue.

I acknowledge this statement

Sport Information

In this section, you will provide information about the sport the child is playing.

Sport or activity grant will be used for(Required)

Please select the sport that most closely aligns with the sport your child is playing

Other Sport(Required)

What sport are you applying for?

How many hours does the child participate in the sport each week?

Please enter a number from 0 to 20.

Sport season start date(Required)

Provide an estimate of when the season is starting

Sport season end date(Required)

Provide an estimate of when the season is ending

Length of Season(Required)

To qualify for the Every kid Sports Pass, you must be registering your child with a program that is at least 4 weeks in length. Please confirm the dates you entered for Season Start Date and End Date are correct. We understand these are estimates and your best guess of when it will start and finish. If the program is shorter in length Every Kid Sports will not be able to support your child.

Youth Sports Organization / School Information

In this section, you will provide the information about the youth sports organization, league, or school that is hosting the sport.

What is the league / organization name?(Required)

(Be specific. Generic names such as, "Parks and Rec", "YMCA", or "City League" will result in an automatic decline.)

Youth Sports Organization (YSO) Website, Facebook, Social Media URL(Required)

Please provide the website your YSO uses for registration or communicating team information.

Contact at Organization(Required)

YSO Contact's First Name YSO Contact's Last Name

Please provide the contact at the organization that can confirm that the season is moving forward.

YSO / School Contact's Email(Required)

Please provide the email for the YSO or primary contact at the YSO.

YSO / School Contact Phone(Required)

Please provide a phone number for the youth sports organization or for the contact you listed at the youth sports organization.

Full Cost of Program(Required)

Please enter a number greater than or equal to 25.

Total cost of fees for the season (or for a 3 month period for programs billed monthly). Need help with this?

Grant Request from Every Kid Sports(Required)

Please enter a number from 25 to 150.

Do not input a number that exceeds the registration cost.

Terms and Conditions

In this section, you will be agreeing to our Terms and Conditions before submitting your application.

General(Required)

Every Kid Sports, at the organization’s discretion, reserves the right to:
1. re-review an application at any time deemed necessary;
2. reverse the decision of an application;
3. remit funds from an approved applicant.

The applicant acknowledges that
4. the awarded funds belong to Every Kid Sports and at no point do the funds belong to the approved applicant;
5. the approved funds are permitted to be used exclusively for the sport and with the organization listed on the application;
6. any use of funds that is deemed “misuse of approved funds,” will forfeit future application opportunities and will be reported to local, state and federal authorities at the discretion of Every Kid Sports;
7. any information provided in the application that appears fraudulent, edited, altered, or any misuse of local, state or federal documents will be subjected to penalties and will be turned over to the proper authorities for prosecution;
8. Every Kid Sports is not responsible for any fines, charges, fees, disqualifications, or penalties that arise from authorities pursuing a case of fraud against the applicant.

I agree to the General Terms and Conditions

Pass(Required)

9. Only parents and/or legal guardian(s) of the child, listed in the application, are permitted to apply for the Every Kid Sports Pass;
10. Leagues, Teams, Advocates, Coaches, Friends, or any other person who is not the parent or league guardian of the child is not permitted to apply for the Every Kid Sports Pass;
11. Applications that do not provide adequate qualifying documentation for the child listed in the application will be declined. Adequate documentation includes SNAP, WIC, or Medicaid documentation that provides the following details: the child's name listed in the application and dates within the last 12 months that show the child is actively enrolled;
12. Every Kid Sports will reject all applications requesting funds for unauthorized leagues, teams, organizations, or any misrepresentation of a youth sports organization and may pursue legal action to the full extent of the law;
13. The applicant acknowledges that Every Kid Sports reserves the right to reject the application for any reason at its sole discretion;
14. Every Kid Sports reserves the right to award only the amount that is verified by the youth sports provider as the registration fees, per child, with a sibling, low-income, or other discounts made available to the family;
15. Attempts to submit falsified Medicaid, SNAP, WIC, or other supporting documents to qualify a child will result in a declined application and will forfeit future use of the Every Kid Sports Pass. If required by state law, Every Kid Sports will file a claim for fraudulent use of Medicaid, SNAP, WIC, or other falsified documents in your application;
16. Parents/Legal Guardians are eligible to receive one grant per child per application season;
17. Every Kid Sports owns the Every Kid Sports Pass rights. Unless Every Kid Sports gives direct approval, the use of the Every Kid Sports Pass as an individual, league, team, school, organization, company or youth sports entity is not permitted.

I accept the Pass Terms and Conditions

Use of Funds Terms and Conditions(Required)

18. The Every Kid Sports Pass only provides funding for future recreational sports, leagues, and teams. The Every Kid Sports Pass funds cannot be paid out for previously paid fees, reimbursements, late fees, or any other use than indicated in the Every Kid Sports Pass application;
19. Attempts to use the Every Kid Sports funds for an establishment other than the youth sports organization listed in your application will result in a decline at the point of sale and funds being automatically retracted; parents with a pattern of misrepresenting the youth sports organization or type of sport they are using the funds for may be banned from applying in the future.
20. The Every Kid Sports Pass approved funds will only be permitted to assist payment towards the registration fees with the youth sports organization listed on the approved application;
21. The Every Kid Sports Pass funds are not permitted for personal money transferring applications and use. Examples include but are not limited to Cash App, Venmo, Zelle, and Xoom;
22. The parent/guardian acknowledges attempts to transfer funds to a personal account will result in Every Kid Sports remitting funds from the user and declining future applications.

I accept the Use of Funds Terms and Conditions

Chek and Remit(Required)

Chek
23. Each household is permitted one Chek account;
24. Households with multiple children will receive all approved funds in the same Chek account.

Remit/Expire
25. The applicant acknowledges that Every Kid Sports reserves the right to remit funds
- for any reason at its sole discretion;
- if the user has not set up their account to access the awarded funds within 30 days of approval;
- prior to the expiration of funds dated on the approval email;
- at any time if the user has used 70% or more of the awarded funds and has remaining funds;
- at any time if the user has funds under $20.00 remaining in their account;
- if the user attempts to use the funds at the youth sports provider for anything other than registration fees;
- if the applicant provides documents that appear fraudulent or falsified to receive funding from the Every Kid Sports Pass;
- if the funds are attempted to be used for an establishment other than the specified youth sports organization in your application;
- for any fraudulent behavior or activity.

I agree to the Chek and Remit Terms and Conditions

I am the Parent/Legal Guardian of the child I am applying for(Required)

I agree

I understand that if approved for an Every Kid Sports Pass I will be contacted by the Every Kid Sports Team to provide a testimonial of the program and/or a photo of my child playing this season(Required)

I agree

The information I have provided for this child's application is both accurate and truthful(Required)

I agree

I would like to subscribe to the Every Kid Sports newsletter(Required)

Yes

No

Every Kid Sports Pass

Parent/Legal Guardian Information

Child Information

Qualification Documentation Upload

Sport Information

Youth Sports Organization / School Information

Additional Information

Terms and Conditions