Konkle Kids Form

Fill out the following form or contact your local community care facility.

Criteria

· Low Family Income 

· Willingness and ability to attend all practices and games

· Ability to provide necessary equipment, footwear, etc. As required by individual league or association.

· Must reside in Lincoln, West Lincoln or Grimsby

· Individuals will be chosen by level of need

Konkle Plumbing & Heating Inc. is not associated and has no financial commitment to any Sporting Association, Group or League. Konkle Plumbing and Heating assumes no liability and is solely providing registration funds (in full or in part) on behalf of the individual player. Registration Funds are paid direct to the League. All Applicant information is kept is strict confidence.

Last Name *

First Name *

Relation to child i.e. Parent, Aunt, Friend etc. *

I agree to *

Attend all games & practices

Provide the necessary equipment, gear etc. required

Address *

Email Address *

Phone #

Child Information *

Male

Female

Sport Coice *

Baseball/Softball Soccer Other

Birthdate D/M/YEAR *

Reason this Child should be considered for the Program *