GOAP Scholarship Application Home / Programs / Scholarships / GOAP Scholarship Application Student InfoName First Last Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Date MM slash DD slash YYYY Male Female Grade123456789School NameEcker HillHomeschoolJeremey RanchMcPolinParleysPark City Day SchoolTrailsideTreasure MountainWeilenmannParent InfoRelationship to Student Mother Father Legal Guardian Name PhoneEmergency Contact Other than those listed aboveName PhoneDoes the student have any allergies or other medical conditions we should be aware of?Program Information Unique to GOAPDoes your child/children participate in the Free and Reduced Lunch Program? Yes No Have you received a YSA scholarship in the past? Yes No Both GOAP & Activ8, not TeamsWhat programs are you applying for?If you require equipment, please list items here:Why should you be considered for a scholarhip? What are your goals for the program in which you are applying? How does being part of this program affect your life? The YSA has 5 core values: Sportsmanship, Perserverance, Optimism, Respect & Teamwork. How does your activity help you gain values & what do they mean to you & your future.Why should you be considered for a scholarhip? What are your goals for the program in which you are applying? How does being part of this program affect your life? The YSA has 5 core values: Sportsmanship, Perserverance, Optimism, Respect & Teamwork. How does your activity help you gain values & what do they mean to you & your future.Terms & Conditions I agree to pay the commitment fee in full. My child will fully participate in the program. If my child does not attend the lessons regularly, I understand that we will not be eligible for a scholarship the following year. I will pick up or make arrangements for pick up of my child by the designated pick-up time for each of the programs. If I or my child does not comply with the above requirements, I am aware that my child may not be eligible to participate the following year. The undersigned hereby agrees to forever release, defend, indemnify and hold harmless the participating venues, clubs, the participating schools, Youth Sports Alliance and its affiliates, organizers, volunteers, and all those involved in the program from any and all liability resulting from claims or lawsuits relating to the provision of medical care to the child including any costs of transportation and provision of medical care. I have read and understand the aforementioned acknowledgment. By signing on behalf of a minor child, I represent and warrant that I am doing so with the consent and approval of my spouse (if any) and I understand that I am acknowledging the risks to my child. * Check this box to indicate that you have read and agree to the terms stated above. Δ
