Apply

If you or a family member has experienced a life-altering injury or death while competing in the arena, please fill out the form below to apply for assistance.

Compassionate copy stressing confidentiality and speed

Eligibility overview

Inside‑the‑arena catastrophic, career‑ending, or life‑altering injuries.

Get Help!

First Name

Last Name

Address

City

State / Province

Zip Code

Phone

Email address

Relationship to Athlete

Incident Details

Incident Date

Date of Birth

Date of Birth

Immediate Needs

Medical Contacts

Consent to Contact/Event verification

We aim to acknowledge within 24–48 hrs (business days).