Donna's Kids - The Donna Weber Sponsored Children's Program

This form must be completed before August 1st for you to qualify for assistance for the 2018/2019 hockey season.
Note: Items marked with an * are required.

...
Section 1: Personal Information

Parent (Guardian)

*
*

*
*
*

*


*

Section 2: Player's Information

*
*

Was your child one of DK’s last year? *

 Yes    No

Male   Female


Goalie/Forward/Defence

*

*

If Possible

If different from above...



Section 3: What type of assistance do you require?

Each of Donna's Kids should pay their insurance fee of $55.00 if possible.

  Partial support
  Full registration support less insurance
  Full registration plus equipment if required
  Complete support. All expenses that the child had including Rep fees and equipment.

Section 4: Equipment Loan Program

Did you receive equipment from KMHA last year? *

 Yes    No

If yes, please indicate what you received.

  •  Helmet/Cage
  •  Shoulder Pads
  •  Skates
  •  Pants
  •  Elbow Pads
  •  Shin Pads
  •  Gloves
  •  Stick
  •  

Does it still fit / in good repair?

 Yes    No

If no, please indicate what you require for this year.

  •  Helmet/Cage
  •  Shoulder Pads
  •  Skates
  •  Pants
  •  Elbow Pads
  •  Shin Pads
  •  Gloves
  •  Stick
  •  

Will you be able to bring in your old equipment for trade in this year?

 Yes    No

The user understands and accepts that while DONNA'S KIDS will be receiving and in possesion of hockey equipment for the entire season, and may in fact keep this equipment in his/her possesion for their entire KMHA career, it is understood that this equipment is the property of the KMHA and Donna's Kids and will be returned and/or traded in for value at Play It Again Sports for the benefit and continuance of this program for future players. Parents/Guardians shall not sell or trade this equipment in anyway shape or form without the prior consent of the Director of The Donna Weber Sponsored Children's Program.

Section 5: Financial Information

Do you receive income from Ontario Works? *

 Yes    No

Social Assistance Details


Are you willing to provide confirmation of income (Pay Stub/Tax Return)? *

 Yes    No

Please note that failure to produce these documents, IF REQUESTED, could result in a decline of this application.

Do you receive income from ODSP?

 Yes    No

Monthly Household Income

*
*
*
National Child Benefit Supplement

*

*

Monthly Household Expenses

*
Mortgage / Rent

*
Car or Public Transit

*
*

*

Household Make-Up

*

*
*

*
*

*
*

Additional Considerations?

This application is recognised as highly confidential and will NOT be discussed with hockey coaches, team managers or even the board of directors of KMHA. Personal names and information are kept under lock and key at an external location, accessible by a limited number of members of the Donna Weber's Sponsored Children's Program (4) and will NOT be divulged to anyone outside of this program whatsoever. Confidentiality agreements have been signed by all members of this committee in order to protect your privacy.

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