This form is for submitting request for season ending injury Booster funding support. Unfortunately, there are times when an LFHS athlete is subjected to a "season ending injury" that inhibits continued play through the end of the season. In support of this athlete's commitment, LFHS Boosters has established a program to provide their team with a $25 payment for a gift to the injured athlete (i.e. plant, book, gift card, etc). To apply for this team payment, the Team Parent must complete this form providing some detail in order to receive this gift. Please note that to be eligible for this payment, the following must apply: 1) The injury must be defined as a season ending injury that will prohibit continued play, and 2) The injury must have occurred prior to the athlete's designated sport play-offs.Name of Requester:* First Last Phone No. of Requester:*Email of Requester:* Make Check Payable to:* First Last Address Where to Send Check:* Street Address City State / Province / Region ZIP / Postal Code Section BreakName of Injured Athlete:* First Last Gender of Athlete's Sport*BoysGirlsSelect the Sport Athlete Played When Injured:*BadmintonBaseballBasketballCheerleadingCross CountryField HockeyFootballGolfGymnasticsIce HockeyLacrossePom PonsSoccerSoftballSwim & DivingTennisTrackVolleyballWater PoloWrestlingIdentify Athlete's Level of Play when Injured:*FreshmanSophomoreJVVarsityConfirm this Injury will Prohibit Continued Sport Participation for Remainder of Season:*YesNoName of Athlete's Head Coach:* First Last Comments: This iframe contains the logic required to handle Ajax powered Gravity Forms.