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LMHS Youth League Scholarship Application

Licking Memorial Health Systems (LMHS) provides registration fee scholarships for children who, without this financial assistance, might not be able to participate in one of Licking County’s youth recreational athletic leagues.  The LMHS Youth League Scholarship program provides opportunities for area youth to participate in recreational team sports as part of our mission to improve the health of the community.  Participation in recreational team sports provides physical, mental and character-building benefits.

Please complete the following form in its entirety. An individual application is required for each child. For more information about the LMHS Youth League Scholarship, please visit the informational page. For suggestions on local leagues for which the scholarship may be applicable, please visit the Sports Activity Resources page. 

Athlete Information
Parent/Guardian Information
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Additional Information
Consent to Release Information