DEADLINE: MARCH 25, 2011

(MUST BE IN THE OFFICE BY DEADLINE TO BE CONSIDERED.)

It is the philosophy of Casper Youth Baseball Board of Directors that every child in our community has the opportunity to play baseball in our program regardless of their ability to meet our registration requirements. We therefore offer scholarships or partial scholarships to assist those in need. However, it is also the feeling of CYB that children should be willing to earn their way through this program. CYB believes this not only helps the league with their financial responsibilities but also teaches our children that they can participate in any event or activity through their own efforts, thus taking pride in knowing that they earned the right to participate. The total registration fee is $155 ($100 of which is earned by fundraising). The $55 registration fee will be waived for Scholarship recipients, however they are expected to earn $100 in fundraising, the amount equivalent to the fundraising efforts of the other players. Scholarship recipients will be issued 10 “Home Run Cards” to sell. All "Home Run Card" money must be turned in by April 25, 2011 to be eligible to participate in CYB games.

Please fill out this brief application form (one per participant) and return it with the registration form to Casper Youth Baseball, Inc., P.O. Box 1966, Casper, WY 82602 or bring it to 2151 W. 13^th Street by March 25, 2011 for consideration for full or partial scholarship. If you have any questions, please call the CYB office at 234-7087.

PLAYER NAME_______________________________________________________AGE____________________________

PARENT/GUARDIAN INFORMATION

FATHER/GUARDIAN _______________________________________________________________________________________

NAME, ADDRESS & HOME PHONE NUMBER

_________________________ ______________________________________________________________________________

OCCUPATION EMPLOYER, ADDRESS & PHONE NUMBER

DOCUMENTED YEARLY INCOME_____________________________________ # IN HOUSEHOLD________________________

MOTHER/GUARDIAN ______________________________________________________________________________________

NAME, ADDRESS & HOME PHONE NUMBER

________________________ _______________________________________________________________________________

OCCUPATION EMPLOYER, ADDRESS & PHONE NUMBER

DOCUMENTED YEARLY INCOME_____________________________________ # IN HOUSEHOLD________________________

I/We are willing to participate in fundraising in order to raise money for the registration fee. We understand that the fundraising money must be turned in by April 25, 2011.

PARENT/GUARDIAN SIGNATURE_______________________________________________DATE________________________