Discover Fun Camp Lottery
General Information
Please be sure to answer all questions accurately. We will contact you based on the information below.
Primary Guardian Name
*
First Name
Last Name
Secondary Guardian Name
First Name
Last Name
Email
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example@example.com
Phone Number
*
Please enter a valid phone number.
Secondary Phone Number
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Does each child live at this address?
*
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Child(ren)'s Information
Let's talk more about your children(ren).
Name
*
First Name
Last Name
Birth Date
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School's Name
*
School's Address
*
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Year
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Postal / Zip Code
Name
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
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September
October
November
December
Month
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1
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5
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1921
1920
Year
School's Name
School's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
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10
11
12
13
14
15
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30
31
Day
Please select a year
2025
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2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
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1981
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Year
School's Name
School's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Verification Section
REMEMBER: The awardees are only individuals selected at random with an annual household income between $70,000-$80,000 or less or have experience a lay off in the last 90 days. The information you provide below will help the organization determine your fixed rate for the 2025 Spring Semester.
Income Verification: Verify your annual household income by submitting ONE of the following forms: A tax return for the previous year, two pay stubs, a Public Assistance Benefit Letter, a TANF letter, lay off email, unemployment verification or a Social Security Benefit letter. Write the title of your verifying document below (ex. TANF letter):
*
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*
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Verify your identity by submitting your driver's license or state-issued ID. Write the type of verification document you will use to verify your identity.
*
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Commitment Statements
By submitting this application for the Discover Fun Camp Aftercare Lottery, I acknowledge that I have read, understood, and agree to abide by the following commitment statements. I understand that failure to comply with these commitments may result in disqualification from the lottery or removal from the program.
No Refunds & Cancellation Policy: I understand that Discover Fun Camp operates on a no-refund policy for aftercare services. If my child is enrolled in the program, I will not be eligible for any refunds under any circumstances. Credits for makeup days will be provided but must be used within the same semester of aftercare enrollment. Unused credits will not roll over to the next semester or be refunded. Please initial
*
Enrollment Commitment (Minimum Attendance Requirement): I acknowledge that if selected in the lottery, my child must be enrolled in the program for a minimum of three (3) days per week. I understand that signing up for fewer than three days will result in disqualification from the program. Please initial
*
Attendance & Tuition Policy: I understand that my child’s tuition will be charged in full for all scheduled days, regardless of attendance. If my child is absent on a scheduled day, I will not receive a refund, but a credit may be applied to a future day within the same semester. Payment Plans are available. I also acknowledge that credits are only valid for the current semester and will not carry over. Please initial
*
Student Behavior Policy: I understand that Discover Fun Camp upholds a zero-tolerance policy for severe behavioral misconduct. If my child engages in any of the following behaviors, their enrollment in the program may be immediately terminated, and their spot will be given to another child on the waitlist: Physical violence, including hitting, punching, or kicking students or staff; Verbal abuse, such as cursing at teachers or students, or making threats; Possession of weapons or dangerous objects; Vandalism, including damaging property or intentionally causing harm to the facility; Leaving the premises without permission or engaging in unsafe behaviors; Any other extreme or unsafe behavior that disrupts the program I understand that if my child is removed due to a behavior violation, I will not receive a refund or credit. Please initial
*
I acknowledge that Discover Fun Camp enforces a strict parent behavior policy to ensure a respectful and safe environment. If I or any authorized guardian engage in any of the following behaviors, my child may be removed from the program, and our account may be permanently deactivated: disrespectful or aggressive behavior towards staff, students, or other parents; threatening language or actions; failure to follow Discover Fun Camp policies and procedures; any behavior deemed inappropriate or disruptive to the program I understand that Discover Fun Camp reserves the right to terminate my child’s enrollment if I violate these standards. Please initial
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I confirm that I have read and understood the Discover Fun Camp Parent Handbook in its entirety. I agree to abide by all policies and procedures outlined in the handbook and will refer to it for guidance on program expectations, operations, and policies. Please initial
*
I acknowledge that participation in this program is determined by a random lottery selection process. No applicants will be prioritized over others, and all selections are final and non-negotiable. If my child is selected in the lottery, I understand that I must accept the placement within the given deadline or it will be offered to another applicant. If I decline or fail to respond in time, my child’s spot will be given to the next eligible applicant on the waitlist. Please initial
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By signing this form, I agree to all terms and conditions outlined above and confirm that I have provided truthful and complete information. Signature
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