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Scholarship Application

  1. The Cottage Grove Parks and Recreation Department believes everyone should have the opportunity to participate and enjoy recreational experiences.
    - All applicants must be residents of the Village or Town of Cottage Grove.
    - No age restrictions apply.
    - This form must be updated at the beginning of each new school year.
    - A copy of the current year’s income tax return and/or current waiver or reduction by the School District for school lunches must accompany this application.
    - Some activities are exempted from the reduction in fees where the program cost is set outside of the Parks and Recreation Department. Inquire with department for program specifics.
    - Scholarship application should be turned in at least one week before program deadline.
    - Payment of 50% of the fee is necessary at the time of program registration.
    - If a program is canceled, you will be refunded only the portion of the fee paid.
  2. Does your child receive reduced or free school lunches?
  3. Waiver for Participant(s)
    In consideration of your accepting this entry, I hereby, for myself, my child, my heirs, executors and administrators, waive and release any and all rights and claims for damages I or my child may have against the Cottage Grove Parks and Recreation, Village of Cottage Grove and it’s representatives, successors and assigns for any and all injuries suffered by myself or my child at any activity sponsored by these groups. Parent or legal guardian must sign for any child under 18 entering the program.

    I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application as may be necessary in arriving at a qualification decision to the scholarship program.
  4. List only household members as shown on your current year income tax return.
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  6. This field is not part of the form submission.