Denver Spartans

Request for Assistance

This form is for players to request assistance for cost of dues and/or equipment use for playing lacrosse for the Denver Spartans during the 2014 lacrosse season. All requests will be reviewed by the coaching staff and you will be notified as to whether assistance is available. Please understand funds are limited but we will do all we can to accommodate all requests. We never want a player ,not be able to play due to a financial issue.

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Birthdate:

* School:

* Grade:

Desired Position - Check all that apply

Goalie

Defense

Mid-field

Attack

* Previous Lacrosse Experience (select one):

* Other Sports Played and When (ex: football 6-11th grade):

PARENT / GUARDIAN #1

* First Name:

* Last Name:

* e-mail:

* Contact Phone #:

Describe what type of aid which is being requested and why? We have the availability to provide aid through assistance with dues and/or helping secure equipment to use for the season.

* :

I / we affirm the above information is correct to the best of my knowledge. *

You can submit this request online or print a blank copy of this form along with a registration form, fill them out and mail them to Denver Spartan Lacrosse 8191 Deep Water Ln. Denver, NC 28037 or scan and e-mail to info@denverspartanslacrosse.com

* indicates required fields

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Request for Assistance