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2021 eks PNW Pass Application Details
The Pass
Section 1: Person Applying
Your Name
*
The person filling out the application
First
Last
Your Email
*
Your Phone
*
Best way to reach you if we have questions
*
Please select
Text
Phone Call
Email
Relationship to Athlete
*
Please select
Parent / Legal Guardian
Other Relative
Friend
Advocate
Youth Sports Organization / School Representative
Other
Other Relationship to Athlete
*
How did you hear about The Pass?
*
Please select
Every Kid Sports website
Social Media (Facebook, Twitter, etc.)
Peachjar Flyer
Rx to Move
McKinney-Vento Advocate
Family Access Network
Youth Sport Provider
Medical Provider
School District
Email
Friend
WIC
Other
Other How Heard
*
Section 1.5: Parent Information
Parent/Guardian Name
*
First
Last
Parent/Guardian's Email:
Please provide, if available!
Parent Cell Phone Number
*
Best Way to Reach Parent
*
Please select
Phone Call
Email
Text
Section 2: Athlete Information
Athlete's Date of Birth
*
Date Format: MM slash DD slash YYYY
Athlete's Name
*
First
Last
School Athlete Attends:
*
Please provide the school the athlete attends. If they are homeschooled, just enter Home School.
Gender
*
Please select
Female
Male
Other
Prefer Not to Answer
Race
*
Please select your racial or ethnic heritage? Choose all that apply. This information is for internal use only. This will not be used to determine eligibility or shared with anyone outside of our organization except as overall statistics.
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latinx
Native Hawaiian or Other Pacific Islander
White
Prefer not to answer
Other
Race2
Please select your racial or ethnic heritage? Choose all that apply. This information is for internal use only. This will not be used to determine eligibility or shared with anyone outside of our organization except as overall statistics.
American Indian or Alaskan Native
Asian
Black or African American
Hispanic or Lantinx
Native Hawaiian or Other Pacific Islander
White
Other
Old field for race
Which of the following best represents your racial or ethnic heritage? Choose all that apply. This information is for internal use only. This will not be used to determine eligibility or shared with anyone outside of our organization except as overall statistics.
Please select
Non-Hispanic White or Euro-American
Black, Afro-Caribbean, or African American
Latinx or Hispanic American
East Asian or Asian American
South Asian or Indian American
Middle Eastern or Arab American
Native American or Alaskan Native
Other
Other Race
Please enter how you define your race.
Will your child like to be an Every Kid Sports All Star?
By checking yes, you are agreeing to send in testimonials, photographs, and videos of your child playing sports that Every Kid Sports can use to promote The Pass. Families that send in content that we use will receive an Every Kid Sports t-shirt for their child.
Yes, we'll be an All Star!
Upload Photo
Use this space to upload an image of your athlete; playing a sport of choice. You can also email
[email protected]
with your images. By uploading a photo of my child, I grant Every Kid Sports permission to use my child's likeness in a photograph, video, or other digital media ("photo") in any and all of its publications, including web-based productions, without payment or other consideration.
Accepted file types: jpg, jpeg, png, pdf.
T-Shirt Size
*
Please provide t-shirt size for your child. Once we received your testimonial and photographs/videos of your child participating in their sport, we will send t-shirt to them.
Please provide size
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Mailing Address
*
Please provide a mailing address for child to receive t-shirt.
Street Address
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Réunion
Saint Barthélemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia
South Korea
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen Islands
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Section 3: Sport Information
Sport or activity grant will be used for
*
Please select
Badminton
Baseball
Basketball
Cheer
Cross Country
Dance
ESA Virtual
Fencing
Field Hockey
Flag Football
Football
Golf
Gymnastics
Hockey
Lacrosse
Martial Arts
Mountain Biking
Skiing/Snowboarding
Soccer
Softball
Swimming
Tennis
Track & Field
Volleyball
Water Polo
Wrestling
Other
Other Sport
*
Please check the drop-down and select a sport. If your child's sport is not listed, please enter sport here.
Sport season start date
*
Date Format: MM slash DD slash YYYY
Sport season end date
*
Date Format: MM slash DD slash YYYY
Hours of participation per week
*
Only enter a numerical value; do not enter words or symbols.
Section 4: Youth Sports Organization / School Information
In this section, you will provide the information about the youth sports organization or school that is hosting the sport.
What organization is hosting your sport? Ex: Park & Rec., High School / Middle School, YMCA, AYSO, etc.
*
Check will be made out to this name. Please check with your YSO, School, or Activity Director and enter the full name.
Organization Hosting the Sport Address
*
This is the mailing address of the Youth Sports Organization or School hosting the sport you are registering the athlete with. Please verify you have the correct MAILING address. Zipcode should only be 5 digits.
Street Address
City
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Zip Code
The Pass is currently only available in Alaska, Arizona, Idaho, Oregon, Montana, Washington, and Wyoming. The Pass will be available nationally soon. Check back often!
Contact at Organization
*
First
Last
Please provide the contact at the organization that can confirm that the season is moving forward.
Contact's Email
*
Please provide the email for the primary contact at the youth sports organization.
Contact's Phone Number
*
Please provide a phone number for the primary contact at the youth sports organization.
Full Cost of the Program
*
What is the full cost of the program if you were to register your child for this program without support.
Grant Request ($150 Max)
*
Not to exceed your child's cost to participate
Qualification Verification
*
Please provide the letter verifying that your child has qualified for Free/Reduced Lunch, WIC, or SNAP, or submit the child's Foster Care Letter. Supported file formats are gif, jpg, png, pdf, heif and jpeg.
Accepted file types: gif, jpg, png, pdf, jpeg, heif.
Old Relationship to Athlete Field - Hidden
Please let us know your role or relationship to athlete
Brought to you by …
donate
national campaign
programs
every kid sports pass
eks pnw amplification
2021 t-mobile little league® call up grant
amped
partners
champions
all-stars
impact
eks jack pinto
blog
news and resources
eks Resources
about
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