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Organization Grant

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Name
Address
Enter program cost per athlete
Minimum Price: $100.00
This field calculates the total cost of grant request.
Season Start Date:
Season End Date:
Please enter 1 to 52.
Disclaimer
I hereby certify that the information provided in this application is true and accurate to the best of my knowledge. I understand that providing false information may result in the rejection of my application. I authorize Gold Rush Senior Hockey to verify the information provided.
Best way to contact you and time of day.
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