Oldham Soccer Club, Inc.
Financial Assistance Application
(updated 6/5/2017)
Player________________________________________Team/age group ____________
Parent/Guardian________________________________Seasonal Year______________
Address________________________________________________________________
Phone ___________ Cell Phone _____________Email __________________________
SS # of player___________________(Required for us to maintain nonprofit status with IRS)
Please explain the reason for a requesting financial assistance. Provide us with all the
information you deem appropriate to help us evaluate your request.
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Please indicate the level of assistance you need:
___ Adjusted payment schedule. Please list dates of requested payment schedule.
Deposit________1st Payment________2nd Payment_______3rd Payment_______
___ Monthly payment plan. Deposit paid with balance split into 9 monthly payments
beginning on August 1st and the first of every month thereafter thru April.
___ Reduced fees. I am able to pay this amount $__________ per season.
Please understand that Oldham Soccer Club cannot absorb fees for items other than your child’s basic
player fee. We cannot pay for uniforms, extra tournament costs or optional camp programs (ex: Elite
Camp) sponsored by Oldham Soccer Club. There is also a limit to the amount of assistance dollars
available per season so evaluation is on a first come, first evaluated service. Payment options are also
only available for fees and not events, camps, etc.
NOTE that despite the outcome of this request, you will be responsible for the costs
of tournament participation, camp or clinic participation, uniform costs, etc.
Consideration for assistance or an adjusted payment plan will be based on financial need,
funds available and previous history with the Club. All requests will be handled
confidentially. If you have any questions, please email Rock Thompson at
[email protected]. Return the completed application by email to the same address
or by regular mail to: Oldham SC P.O. Box 464 Buckner, KY 40010.
If approved, the Club requests that parents ensure player(s) attend all team functions for
which the financial assistance is provided. Also, it is expected that parents will volunteer
their time to help the club at Derby Cup or other club activities. Our response to your
request will be forwarded to you to the email you indicated above.
Parent Agreement:
I understand and agree to the above guidelines and further recognize that if I do not adhere
to this agreement, I may be subject to financial penalty or my player’s suspension from
play with their team until full payment has been made.
Parent/Guardian Signature:__________________________________ Date:___________