Grand Valley lacrosse is a Non-Profit 501-C-3 organization dedicated to benefiting the youth of the Grand Valley including Fruita, Grand Junction, Central and Palisade. We do not want financial hardship to be in the way of an opportunity for children to be able to participate in the program. We recognize that the cost of registration and that the purchase price of lacrosse equipment is significant. Grand Valley Lacrosse is prepared to consider assistance based on need. A specific scholarship form must be filled out. Scholarships will be determined by the executive committee of the board of directors by the deadline. The High School deadline Feb 15th and youth deadline is March 6th. Any one receiving a scholarship will be required to volunteer for Grand Valley Lacrosse. A list of volunteer opportunities will be available and we expect your assistance.
Scholarships will be only for the registration fee not for equipment. The player will be responsible for their own equipment
Should you want more information on such assistance please contact Robin Heil 241 7520 or
All such inquiries will be held in strict confidence.
The form can be found below:
Requirements for eligibility:
�� Athlete must be age 19 or younger.
�� Commitment to attend a minimum of 80% of scheduled practices and games.
�� Participation by a family member in at least one (1) volunteer opportunity during the scholarship season.
�� Application must be completed by a parent, guardian, or head of household, with all requested information provided. (Incomplete applications will not be considered.)
Priority will be given to eligible youth meeting one or more of the criteria below:
�� Member of a multi-child family.
�� Living in a single parent home.
�� Receiving assistance from programs such as: Food Stamps, Medicaid, SSI, Foster Care, WIC, etc. (Must provide written documentation of participation in these programs to receive priority status)
��Written recommendation by school representatives, social workers, youth community center workers, or other social services representatives.
�� A 2.5 (4.0 scale) cumulative G.P.A. or better
�� No record of serious disciplinary problems
**Approval of a registration scholarship does not register the participant in the activity. Athlete must still register with the league.**
GRAND VALLEY LACROSSE REGISTRATION SCHOLARSHIP APPLICATION
Please complete the following information, one application per child:
Athlete’s Name:____________________________Age:_____ Male/Female Birthdate:_______
Address:_____________________________________________________________________
Street City State Zip
School Athlete Attends:________________________________ Grade:___________________
Teacher’s Name:___________________________School_____________ Phone #:__________
Athlete lives with: ( ) Both Parents ( ) Mother ( ) Father ( ) Other
Amount of scholarship requested: Full $___________________ Partial $__________________
PARENT / GUARDIAN INFORMATION:
Total Household Annual Income: $_____________________________________
Number of dependent children in your household during the last tax year:_________
Father’s Name:________________________Occupation:_________________
Home Phone:______________Work Phone:_____________E-Mail:_______________
Mother’s Name:_______________________Occupation:___________
Home Phone:_______________Work Phone:______________ E-mail:______________
Guardian’s Name:______________________Occupation:_____________________
Home Phone:__________________________ Work Phone: E-mail:______________
Has this athlete ever received scholarships from the GV LAX before? ( ) Yes ( ) No
If yes: Which Year_______ Amount $ ____________
CONSENT TO RELEASE INFORMATION
I understand that my signature authorizes GVLAX to obtain verification of all information on this application and that additional information may be necessary for approval of this application. I certify that all of the information on this form is true and correct. I understand that my child(ren)’s participation in this program requires a commitment to attend a minimum of 80% of the scheduled practices and games and that I will participate in at least one volunteer opportunity during the scholarship season.
_________________________ _____________________________
Parent/Guardian Signature Date GVLAX Board President Signature Date
