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About Us
Become a Member
Board of Directors
Resources
Adaptive Sports
Disability Resources
Reimbursement Programs
Contact Us
Join
Donate
Physical Fitness Fund Application
Date of Application
(Required)
MM slash DD slash YYYY
Name of Person (with SB, hydrocephalus or related neural tube defect) Requesting Aid
(Required)
Address
County of Residence
City
State
Zip
Phone Number
(Required)
Email
(Required)
Check One
Child
Adult
Date of Birth
MM slash DD slash YYYY
If child, name of parent requesting grant
How long have you been a member of the SBWNY?
Which SBWNY Committee or function have you been assisting with?
Amount of aid requested?
(maximum of $500 per calendar year)
For consideration, please briefly describe the activity and how you or your child benefits from it:
PHYSICAL FITNESS FUND RULES OF OPERATION
Effective September 27, 2023
The Spina Bifida of Western New York (SBWNY) Board of Directors reserves the right to amend these rules and to discontinue this fund if/when funds have been depleted.
All fund recipients are encouraged to be members of the SBWNY.
All fund recipients are encouraged to volunteer on a committee or assist with a SBWNY function or fundraiser. Fund recipients will be added to a volunteer database and they may be called upon occasionally to assist with functions and/or fundraisers.
All fund recipients must reside in SBWNY’s service area, which includes only the following New York counties: Erie, Niagara, Allegany, Orleans, Cattaraugus, Chautauqua, Wyoming, and Genesee.
Original receipts must accompany all fund requests.
Applications for reimbursement of prior year expenditures must be submitted no later than March 31. No prior year applications will be accepted after that date.
Physical Fitness Fund applications may be made by individuals with spina bifida and/or hydrocephalus to help defray costs related to physical fitness activities including but not limited to memberships and fees for gyms and/or athletic facilities, exercise and/or fitness classes, adapted sports programs, therapeutic horseback riding and various weight-loss programs.
Funds are available up to a yearly maximum of $500.00 per person, based on the availability of funds. Grant eligibility and amount are solely at the discretion of the fund’s administrative committee. Funds are not guaranteed. In the event that an application is denied, the applicant will be notified in writing./li>
An application, along with original receipts, must be submitted with each request. The SBWNY treasurer will issue payment within 30 days of receipt of the administrative committee’s approval and depending upon availability of funds.
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