Assistance Application

Partnership between;

Cochrane Canadian Tire Jumpstart and SLS FSC

SLS FSC - Spray Lake Sawmills Family Sports Centre is a chapter member of the Canadian Tire Jumpstart Program - Cochrane location.

Mandate of Canadian Tire Jumpstart: To provide financially disadvantaged children in Canada with the opportunity to participate in sport and recreational activities.

Criteria for funding:

  • Funding assists financially disadvantaged families in getting their children involved in sport and recreational activities. Funds Requested are SUBJECT TO AVAILABILITY and not a guarantee.
  • Funding is made possible from the local Cochrane - Canadian Tire Jumpstart branch
  • Children between 4 and 18 years of age
  • Funding is available for all children that require financial assistance
  • Funds are paid directly to SLS FSC or the sport association but not the family
  • Funding can be requested for more than one child in a family
  • Sport or recreational activity must include physical activity
  • Funding: per submission to a maximum of $300/activity, twice a year (Example; hockey registration and a one week day camp, soccer registration and a swim lesson, two weeks of day camp, swim team registration and a soccer registration, curling registration and a swim lesson, gymnastics registration and a swim lesson, SLS FSC Youth fitness membership…)
  • Funding can be used for; an SLS FSC sustained program that is either a minimum of 5 weeks in length with a minimum of one session per week or a Fit Kid Summer Sport Camps (must be 5 consecutive days)
  • Funding can be requested for a sport example: Soccer, Hockey, Ringette, Gymnastics, Baseball, P3 Spring Hockey, Shooters 3 on 3, Dance, Figure Skating, Curling, Swimming,

Please complete the attached Canadian Tire Jumpstart Application form andMUST include copy of most recent T-4and submit it to:

Robin Mitchell, General Manager & Executive Director

Spray Lake Sawmills Family Sports Centre

800 Griffin Road East, Cochrane AB, T4C 2B8

*please complete all 3 sections

SECTION 1: Application information

Childs Name:______Age: ______Birth Date:______

Male/Female (circle)

Parent/ Guardian Name:______Address:______Postal Code:______

Phone:______E-mail:______

SECTION 2: Request for funding

Program / Day Camp / Sport / Activity:______

Start date:______End date:______#of sessions______Length of each session:______

Cost of sport or activity:______

$ Request from Jumpstart:______(max $300 per submission, twice year)

SECTION 3: Endorsement

(examples; Teacher/Guidance Counselor/Pastor/FCSS/Lawyer/Doctor/Person that knows the family situation)Can’t be an administrator or coach of the Sport being applied to

Name:______

Address:______

Phone:______E-mail:______

Relationship to applicant:______

Endorsement of the child. Please provide a brief written support for the participant as to why they should be considered for the program, day camp, sport, activity:______

Signature:______Date:______

SLS FSC OFFICE USE ONLY

Date application received______Accepted Y / N T-4 attached Y / N

Funding amount: $______

Reason:______

Follow up:______

*CanadianTire Jumpstart and SLS FSC will respect the confidentiality of all applicants. By completing this application, I hereby authorize Canadian Tire / SLS FSC to contact me and / or the endorser of this application.