Revised 05.28.2024
Youth Community Promotional Fund Policy Noble Fitness Inc.
Youth Community Promotional Fund Check List:
Listed below is a check list of all required documents to submit an application for the Youth Community Promotional Funds. Please refer to this list as a guideline to ensure a complete application.
Document Check List
Document Details D8512192025
Current Non-Profit Status (501c) 1. Documentation showing current status. CP
2. Latest 990 Form. Initial:
1. Provide a detailed breakdown of 8.1212025
Breakdown of Services and Cost
what services are being provided.
2. Provide a detailed breakdown of
the cost to the Residents of
Barstow. Initial:
8112-20251
Two Year Plan 1. Provide a detailed explanation of
goals for the organization for the
next two years.
2. Provide a detailed explanation of OP
operations for the next two years. Initial:
Detailed explanation of how the 8. 1212025
Donation Benefit 1.
donation will benefit the
organization.
2. Detailed explanation of how this
donation will cut down the cost to
the Residents of Barstow. Initial:
Include a copy of a certificate of liability 1,9,200
Certificate of Liability Insurance
insurance. Policy must be a $1,000,000
policy listing the City of Barstow as
additionally insured. CP
, Initial:
Provide a detailed explanation of what - 8 т 127 2025-
Background Checks Procedures
procedures are being used to conduct
backgrounds checks for members of the OP
organization. Initial:
Show evidence and proof of funds 8.12.2025
Evidence or Proof of Funds
demonstrating that the City is not the only
funding source, by presenting additional Initial: CP
funding contributions.
Verified By:
1: "and
CITY OF BARSTOW
BARSTY! YOUTH COMMUNITY PROMOTIONAL FUND
APPLICATION
APPLICANT INFORMATION Name of Organization:
! Name of Applicant:
Noble Strong Inc.
James Noble
Mailing Address: 1264 East Main Street ]Zip: 92311
"State: CA
City: Barstow
Telephone: (760) 953-0831 /Email: [email protected]
No 0 TiNo, are you planning on partnering with a non-
Non-Profit: Yes M Yes O No D
profit?
501(cX3)#: 87-3681224
EVENT DESCRIPTION
Name of Event:
Barstow Youth Flag Football
Dateis, of Event: | Location:
3/24/26-5/17/26 1610 Rimrock Rd. Barstow CA 92311
# of Participants: 150
WAIVER OF FEES DESCRIPTION Date(s):
| Park/Facility
Total:
Fees: $
Rental Fee: $ /hr x
/hr x hrs
Lights: S Total Fees Waived: $
MATERIAL DESCRIPTION Quantity Ünit Cost ! Total
$25 $625
25 Flags $45 $540
12 Footbalis 2 145 290
Scoreboard
$297 Total: 61,752
Speaker
Papa 1
Youth Community Promotional Fund Application
Why is your organization requesting funding?
Our organization is requesting an funding to support our youth flag football league beceuse we are committed , to providing accessible and enriching sports experiences for the young people in our community. Many of the tam port sty to priate, regarles of the commi stution. By continue our tenge oil han investing in the physical health, social development, and overall well-being of our youth, fostering a sense of community, teamwork, and discipline that will benefit them throughout their lives. Your support will enable us to i offer a high-quality program that promates positive values and helpe our youth build character in a safe, supportive environment.
"2. How will this donation benefit your organization and the youth population of Barstow? (ensuring our youth flag football league runs smoothly. It will help us create an inclusive environment where all This in-kind donation will allow our organization to provide essential resources like equipment and uniforms, 'quality program that promotes physical activity, teamwork, and life skills, fostering a positive community and children in Barstow can participate, regardless of financial background. For the youth, this means access to a empowering future leaders.
agree to all its terms and conditions. I agree that there is a formal process in place to conduct By signing below, I declare that I have read the Youth Community Promotional Fund Policy and years and senior citizens. I understand that an incomplete application will not be accepted and background checks on all employees and volunteers who work with persons under the age of 18 submitted on behalf of an organization or school, an additional signature is required.) that the organization or applicant will not be considered for funding. (If the application is being James Noble lI
Applicant Name (printed)
Applicant Signature
9/28/2025
Date
Organization President/Director Signature
(it applicable)
Papa?
Youth Community Promotional Fund Application
The donation will play a critical role in strengthening the Flag Football League and ensuring its sustainability while enhancing the overall experience for players, families, and the community.
Below are key ways the donation will directly benefit the organization:
1. Financial Stability & Growth
• Provides immediate financial relief, allowing the league to focus on expansion and long-term sustainability.
• Helps secure essential resources without relying solely on participant fees, making the league more accessible to families.
• Allows for additional outreach and marketing to attract more participants.
2. Equipment & Uniforms
• Covers costs for purchasing high-quality footballs, flags, cones, and other essential game-day equipment.
• Provides free or discounted team shirts/jerseys, ensuring all players have proper uniforms for games.
• Ensures safe and standardized equipment is available for all age divisions.
3. Lowering Barriers for Participation
• Supports scholarship programs for children from low-income families, ensuring no child is left out due to financial struggles.
• Allows for reduced or eliminated registration fees for certain participants, making the league more inclusive.
• Covers additional operational costs that would otherwise be passed on to families.
4. Enhancing Game-Day Operations
• Funds referee payments, ensuring fair and professionally officiated games. • Supports game-day setup, including field markers, scoreboards, and seating areas for Helps cover liability insurance and medical supplies to prioritize player safety.
1. Barstow Youth Flag Football League
The Flag Football League offers the following services to the residents of Barstow:
League Structure & Organization:
Organized divisions based on age groups to ensure fair competition. • Team formation, schedules, and structured game-day operations.
End-of-season championship and awards ceremony.
Training & Development:
• Rules and gameplay education for new players.
Game Day Operations:
• Referees and official scorekeeping.
• Field setup, including cones, flags, and goal markers. • First aid and safety measures in place during games.
Player & Team Benefits:
• Team shirts/jerseys for all players.
• Equipment provided (flags, footballs, cones, and markers). • Championship awards.
Community Engagement:
• Family-friendly event.
• Volunteer and youth mentorship opportunities.
• Potential scholarship opportunities for families needing financial assistance.
2. Breakdown of Costs to Residents of Barstow
The cost per resident depends on league expenses and the level of financial support received from donors. Below is a breakdown of anticipated costs:
Expense Category Estimated Cost Per Total League Cost (for example, Participant 150 players)
Player Registration Fee $75 Per Player $11,250
Team Jerseys & $0 per player $0
Equipment
Referees & $20 per game per $2,240
Scorekeepers(4)
Field Setup & Included Covered
Maintenance
Awards & Championship $4 per player $600
Trophies
Administrative & $5 - $10 per player $500 - $1,000
Marketing
Insurance & Safety $5 - $10 per player $500 - $1,000
Supplies
Total Estimated Cost Per Player: $75
Date:
Department of the Treasury
Internal Revenue Service 07/05/2023
Tax Exempt and Government Entities Employer ID number:
IRS P.O. Box 2508 87-3681224
Cincinnati, OH 45201 Person to contact:
Name: Customer Service
ID number: 31954
Telephone: 877-829-5500
Accounting perlod ending:
NOBLE STRONG INC December 31
1264 EAST MAIN STREET Public charity status:
BARSTOW, CA 92311 170(b)(1)(A) (vi)
Farm 990 / 990-EZ / 990-N required:
Yes
Effective date of exemption:
November 16, 2021
Contribution deductiblily;
Yes
Addendum applies:
No
DLN:
26053574002383
Dear Applicant:
We're pleased to tell you we determined you're exempt from federal income tax under Internal Revenue Code (IRC) Section 501(c)(3). Donors can deduct contributions they make to you under IRC Section 170. You're also letter could help resolve questions on your exempt status. Please keep it for your records. qualified to receive tax deductible bequests, devises, transfers or gifts under Section 2055, 2106, or 2522. This foundations. We determined you're a public charity under the IRC Section listed at the top of this letter. Organizations exempt under IRC Section 501(c)(3) are further classified as cither public charities or private you're required to file an annual information return (Form 990 or Form 990-EZ) or electronic notice (Form If we indicated at the top of this letter that you're required to file Form 990/990-EZ/990-N, our records show 990-N, the e-Postcard). If you don't file a required return or notice for three consecutive years, your exempt status will be automatically revoked.
If we indicated at the top of this letter that an addendum applies, the enclosed addendum is an integral part of this letter.
Enter "4221-PC" in the search bar to view Publication 4221-PC, Compliance Guide for 501(c)(3) Public For important information about your responsibilities as a tax-exempt organization, go to www.irs.gov/charities.
Charities, which describes your recordkeeping, reporting, and disclosure requirements.
Sincerely,
shephere a. martis
Stephen A. Martin
Director, Exempt Organizations
Rulings and Agreements
Letter 947 (Rev. 2-2020)
Catalog Number 35152P
NOBLFIT-01 JANETL
DATE (MM/DD/YYYY)
ACORD® CERTIFICATE OF LIABILITY INSURANCE 1/9/2026
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed abject to the terms and conditions of the policy, certain policies may require an endorsement. A statement I SUBROGATION IS WAIVED, is certificate does not confer richts to the certificate holder in lieu of such endorsement/ PRODUCER License # 0252636 HANTACT
:760 256-3566 70) 256-3974
United Agencies
109 E Fredricks Street E-MAII
ADDRES-
Barstow, CA 92311 NAIC #
INSURERS AFFORDING COVERAGE
INSURER A: Hiscox Insurance Company Inc. 10200
INSURER B:
INSURED
INSURER C:
Noble Fitness
1264 East Main INSURER D:
Street Barstow, CA INSURER E:
92311
INSURER F:
CERTIFICATE NUMBER: REVISION NUMBER:
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, INDICATED.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFI LIMITS
INSR ADDL SUBR POLICY NUMBER MDDIYYY
TYPE OF INSURANCE NSO 1,000,000
EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY AMAGE TO RENTE 100,000
CLAIMS-MADE X OCCUR 10/1/2025 10/1/2026
XX P101.919.985.4 5,000
MED EXP Any one person
PERSONAL & ADV INJURY 2,000,000
2,000,000
GENERAL AGGREGATE
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
X POLICY LOC
OTHER: COMBINED SINGLEMIT
AUTOMOBILE LIABILITY
BODILY INJURY (Per person)
ANY AUTO
BODILY INJURY Per accident
AUTOS ONLY
HUTES ONLY
EACH OCCURRENCE
UMBRELLA LIAB OCCUR
CLAIMS-MADE AGGREGATE
EXCESS LIAB
DED RETENTION 5
PERTUTE !
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE S
E.L. DISEASE - POLICY LIMIT $
BYSCRISTON OF OPERATIONS below
Ply or Barstow is named ofional BEES CORD 101, Alonal Ramaka schedule, may be attached more space is requiredy
CERTIFICATE HOLDER CANCELLATION
EXPIRATION
City of Barstow
220 E Mountain View St, Ste A
Barstow, CA 92311 AUTHORIZED REPRESENTATVE
© 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25(2016/03)
The ACORD name and logo are registered marks of ACORD
Joint Special Council/BFPD
TIE OF THE LO 02/3/26 06:00 PM
Parks and Recreation
BARSTOW Chelsea Phillips
Community Promotion
Doc ID: 6256
AGENDA ITEM
AGENDA MATTER:
AWARD OF MEASURE Q YOUTH COMMUNITY PROMOTIONAL FUNDS FY 25-26 EXECUTIVE SUMMARY:
The Fiscal Year 2025-2026 Budget was adopted which includes an appropriation from Measure Q Fund for seniors and youth sports programs. Measure Q Funds are allocated towards providing in-kind resources and services to youth sports organizations that provide social and economic benefits and/or recognition to the community.
DISCUSSION:
At the December 16, 2019 City Council meeting, the Youth Community Promotional Fund Policy was adopted. The purpose of this proposed policy is to establish guidelines for providing in-kind resources anc services to youth sports organizations that provide social and economic benefits and/or recognition to the community. A total of 7 applications were submitted to the Park and Recreation Department. All 7 of the applications have met the requirements for the Measure Q application. Staff recommends awarding a total of $29,831 of Measure Q Funds for Equipment to be split amongst the 7 applicants and $43,200 in in-kind fee waivers for field usage.
FISCAL IMPACT:
$29,831 charged to Measure Q Youth Fund Account No. 102.150.542.07.770 and $43,200 of donations for field usage fees.
RECOMMENDED ACTION:
Authorize the allocation of $29,831 from the Measure Q Funds towards providing equipment and $43,200 in field usage fee waivers to the youth sports organizations.