Reporting Tool. Instructions

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Luke Carpenter
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1 Instructions Reporting Tool The Sport, Recreation and Youth Division will use this reporting tool for the Program supported by funding from the Department of Municipal and Community Affairs (MACA). This is part of the division s efforts to support effective local sport programming, athletes and coaches in smaller communities and is intended to improve youth participation in physical activity, leading to positive lifestyles. MACA encourages sport and recreation organizations and school authorities to organize and host regional youth sport events. Organization 1 : Name of event: Date(s) and location of event: The Reporting Tool for the Regional Youth Sport Events Contributions Program must be submitted no later than 60 days after completion of the event! Please attach your financial statement for the program showing all revenues (Regional Youth Sport Event Contribution, fees, other funding sources, fundraising, etc.) for the project and all expenditures. Please include the total expenses for the project and identify expenses eligible under the Policy. 1 The Sport and Recreation Organization or School Authority that filed the Application Form to apply for funding through the Regional Youth Sport Events Contribution Program.

leading to positive lifestyles. MACA encourages sport and recreation organizations and school authorities to organize and host regional youth sport events.

2 Please submit this application to your respective regional office: Colin MacPherson Shane Thompson Conan Donahue South Slave Regional Office Dehcho Regional Office North Slave Regional Office Municipal and Community Affairs Municipal and Community Affairs Municipal and Community Affairs Box 127 Box 240 Box 1320 Fort Smith, NT X0E 0P0 Fort Simpson, NT X0E 0N0 Yellowknife, NT X1A 2L9 Phone : (867) Phone : (867) Phone : (867) Fax : (867) Fax : (867) Fax : (867) colin_macpherson@gov.nt.ca shane_thompson@gov.nt.ca conan_donahue@gov.nt.ca Amanda Feltham Sahtu Regional Office Donald Kuptana Inuvik Regional Office Municipal and Community Affairs Municipal and Community Affairs Box 70 Bag Service #1 Norman Wells, NT X0E 0V0 Inuvik, NT X0E 0T0 Phone : (867) Phone : (867) Fax : (867) Fax : (867) amanda_feltham@gov.nt.ca donald_kuptana@gov.nt.ca

: (867) 872 6533 Phone : (867) 695 7224 Phone : (867) 392 6328 Fax : (867) 872 6526 Fax : (867) 695 2029 Fax : (867) 392 6312 Email: colin_macpherson@gov.nt.ca Email: shane_thompson@gov.nt.ca Email: conan_donahue@gov.

3 Identify if this activity is training event, clinic, competition or combination and for whom (athletes, coaches, officials and volunteers)? Host community: School, Sport Group or Community Government Involved: Sport Start Date: Activity Start Date (dd/mm/yyyy) End Date: Activity End Date (dd/mm/yyyy) Age (Indicate the target age group for the activity) Child 0 5 Child 6 8 Child 9 12 Child Adult 17+ M F M F M F M F M F Number of Volunteer Hours Involved M Number of Volunteer Involved F Participant Information Male Female Data Total Data Total Number of Participants Number of Participants First time Participants First time Participants Aboriginal Aboriginal Persons with a Disability Persons with a Disability

age group for the activity) Child 0 5 Child 6 8 Child 9 12 Child 13 16 Adult 17+ M F M F M F M F M F Number of Volunteer Hours Involved 0 10 10-20 20-30 30-40 40 + M Number of Volunteer

4 Financial Information (Enter total activity cost and total funding received from MACA) Total Activity Cost: Total MACA Funding Requested: Total MACA Funding Approved: Please attach financial statements to the Activity Report, if they are available; if not, please submit these at year-end. Additional Information If you have any photographs from this activity, newspaper articles about the activity, or other interesting information that you would like to share, please include these with your report. Submitted by (Signature) Date

5 Appendix A Regional Youth Sport Events Contribution Program Financial Reporting Template Revenue(s) Value Expenditure(s) Value Regional Youth Sport Events Contributions Donations Fees Other Funding sources Community Contributions Volunteers Local Business Other: Total Revenues Equipment Food Facilities Staff Officials Freight Materials* Other: Total Expenditures Administration Fees will not be accepted. *-Including Medals, T-shirts, Banners, etc.

Contributions Volunteers Local Business Other: Total Revenues Equipment Food Facilities Staff Officials Freight

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