January For more information visit gameonwales.org and follow us on our social media channels.

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Game on Gear January 2017 Game On Wales is a Coalfields Regeneration Trust s social inclusion project. Using sport as an engagement tool, Game On aims to promote healthy lifestyles, active citizenship, volunteering, education, employment opportunities and community development. With multiple projects operating throughout the year, we aim to address issues affecting individuals and communities in former coalfield areas such as anti-social behaviour, training needs, social exclusion and socio-economic barriers preventing people accessing sporting and community opportunities. The aim of the fund is to support sporting activities which increase active participation of individuals from disadvantaged former mining communities. Applications are particularly encouraged from groups supporting young people under 25 years of age. Applicants will need to demonstrate how they have identified barriers to participation and evidence the need for the funding. In addition, Game On can support Clubs and sporting activities to increase their sustainability with social enterprise business and fundraising advice. For more information visit gameonwales.org and follow us on our social media channels. If you have any queries, please email info@gameonwales.org or call 01443 495938. V2 17/01/17 Page 1 of 10

The Game On Gear fund can award two levels of grants: Fast track applications under 500 The Fast Track application is for sports teams from former coalmining communities who require start-up and/or fund-raising support. A Fast Track form will be completed by the applicant and returned to the Game On Wales team for assessment. If approved, you will be referred to our preferred suppliers to make arrangements for your new sports kit. Applications of 500.00 or above Applications equalling, or in excess of 500.00 will be considered in exceptional circumstances. In order for us to consider such applications, your request would have to score highly against our assessment criteria and have wider community aims. We will also require additional information on your organisation, including a governing document, a recent bank statement (in your organisation s name and no more than three months old) and a copy of your annual accounts. With the above in mind, applications equalling or in excess of 500.00 will be subject to approval from the Coalfields Regeneration Trust Welsh Committee which meets quarterly V2 17/01/17 Page 2 of 10.

Preferred Supplier Macron Store Cardiff is able to supply a wide range of kits for a variety of sports. Payment of the invoice will be made directly to Macron Store Cardiff by the Coalfields Regeneration Trust. Should we agree that they cannot meet your requirements adequately, we will ask you to supply a detailed quotation from an alternative supplier. Customisation of your sports kit If your application is successful, you will be required to complete a kit order form and will be offered a variety of Macron kit options to choose from. Your kit will be embroidered with your club crest, will feature Game On Wales as a front and centre principal sponsor and will also incorporate the Coalfields Regeneration Trust s logo. Additional customisation Any customisation in addition to the above will have to be agreed with Macron Store Cardiff and any additional costs met by the club. Additional Costs Should your kit order exceed 499.99, your application will be assessed for eligibility for a higher grant award or you will be required to pay the balance of your order to the supplier before collecting the kit. Multiple Applications We will not consider more than one application from the same club within a calendar year. V2 17/01/17 Page 3 of 10

Grant Assessment Information Fast Track Assessment Process and Criteria Your application will be reviewed by Game On Wales and the Coalfields Regeneration Trust staff and assessed upon criteria including but not limited to; geographical area, project aims, community impact and sustainability. Funding Periods When launching a round of funding we will specify a deadline date. If the round of funding is fully allocated before the deadline date, we will close that round of funding. Should we close a funding period early, we will carry over any outstanding applications to the next period. For details of the current round of funding, please visit the Game On Wales website. V2 17/01/17 Page 4 of 10

Approval Conditions Publicity As part of an agreement, your team will be required to take part in a publicity event to promote the scheme and your club. This event should take place within one month of the kit being received. Case Study You will be required to provide a short progress report on what has been achieved with the grant period, should you need any guidance with this, we will be happy to help. Your Information As part of the application process, your contact details will be securely stored by Game On Wales and the Coalfields Regeneration Trust, we will not share this information with any third party organisations without your prior consent. Should you have any queries please contact (01443) 495938 or email info@gameonwales.org V2 17/01/17 Page 5 of 10

Application Form (Please complete all sections) Contact Information Contact Name: Full Contact Address (inc. Post Code): Post Code: Position in Club/Organisation/Group: Telephone Number(s): Email: Team/Organisation/Group Name and address and post code (this could be a clubhouse or facility/pitch): Name: Full Address: Post Code: V2 17/01/17 Page 6 of 10

Your Aims and Objectives What does your organisation do? What barriers to participation have you identified? How will this project increase participation? How many people do you think will benefit from the grant? What ages will they be? How many volunteers will support the group and in what capacity? e.g. coach / secretary /fundraising / washing kit /other (please specify) V2 17/01/17 Page 7 of 10

Grant Information If you require more than 499.99, how will the balance be met?* *if the balance is to be met by the club s own funds, you must demonstrate that you have sufficient funds available in advance of any order being placed. Bank Account Does your club have its own bank account? Yes / No (Please delete as applicable) If you have answered yes to the above question, please provide a recent (no more than three months old), original bank statement or printed online bank statement (online statements must be signed by two committee members). Tick here to confirm this has been included: Declaration I/we the undersigned confirm that the group named has authorised me/us to sign the application and contract on their behalf and that as far as I/we know, all the information I/we have given in this application is true and correct. I/we understand and accept that the group may have to provide more information about the application before a decision is reached. I/we agree to adhere to the terms and conditions of this application. Signed: Date: Please return completed forms to the Game On Wales Team at: info@gameonwales.org or Game On Wales, Unit 1 Maritime Offices, Woodlands Terrace, Pontypridd, CF37 1DZ. Please read the terms and conditions before completing your application. V2 17/01/17 Page 8 of 10

Terms and Conditions 1. I understand that any award made must be spent as itemised within this application. Any changes must be approved by The Coalfields Regeneration Trust prior to making any commitments. 2. I understand that my organisation must supply any monitoring information required by The Coalfields Regeneration Trust. 3. I understand that any underspend of a Grant by my organisation must be identified, and returned to The Coalfields Regeneration Trust. 4. I understand that the Trust will hold data in accordance with the Data Protection Act 1998. 5. I confirm that we are aware of the duty of care to Children, Young People and Vulnerable Adults and have taken necessary steps to comply with the legal requirements. 6. As far as I know, all the information we have given in this application is true and correct. I understand and accept that the group may have to provide more information about the application before a decision is reached. 7. I accept that your decision is final. 8. If all or part of this application is successful, we will keep to the terms set out in the contract above or contained in the offer letter (or both). 9. I confirm that the group named has authorised me to sign the application on their behalf. 10. I confirm that the group named understands that the Trust reserves the right to reclaim all or part of the grant award, should we fail to honour any part of the contract. 11. I agree that you may use the information we have provided. 12. I understand the group named will be expected to participate in a publicity event regarding this grant and provide a short progress report on what has been achieved with the grant period along with proof of expenditure (where applicable). 13. Payment of an approved grant will be made directly to Macron Store Cardiff from the Coalfields Regeneration Trust. 14. If Macron are unable to meet our requirements I understand the Trust will consider quotations from other suppliers. 15. I understand that our kit will feature the Game On Wales and Coalfields Regeneration Trust logos as described in the Customisation of your sports kit section of the Guidance Notes document. 16. I confirm we have not applied for this fund previously in this calendar year. V2 17/01/17 Page 9 of 10

Kit Order Form Please retain this document until you receive notification that your application is successful If your application is approved, our preferred supplier for your kit is the Macron Store Cardiff. Please complete the form below and return it to Game On Wales. Payment of an approved grant will be made directly to Macron Store Cardiff from the Coalfields Regeneration Trust. If Macron are unable to meet your requirements we will consider quotations from other suppliers. Please choose your desired style and colour and enter them in the table below. Fittings can be arranged with Macron Store Cardiff on an appointment only basis. Should you require a fitting and are unable to visit Macron Store Cardiff, please contact Game On Wales to make alternate arrangements. Visit their website for more information macronstorecardiff.co.uk. What kit/uniform do you want to apply for? Sport: Number of Kits: Club & Age Group: Sizes (please enter quantity required per size): 3XS: 2XS: XS: S: M: L: XL: 2XL: 3XL: Colours (As per Macron description) Shirt: Shorts: Socks: Style (As per Macron description) Shirt: Shorts: Socks: Contact details: V2 17/01/17 Page 10 of 10