2025 Aquatic Free/Reduced Swim Application
This form must be completed to be considered for Youth Free Swim Admission and/or Reduced-Cost Swim Lesson Program Please submit one application per participant.
Please select the following program you would like to be approved for.
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Reduced - Cost Swim Lesson for Youth 6 months - 17 years
Reduced - Cost Swim Lesson for Adults 18+
Participants Name
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First Name
Last Name
Participants Age
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Participants Birthdate
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Month
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Day
Year
Date
Parent/Guardian Name (If over the age of 18, please put N/A):
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Contact Number:
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Please enter a valid phone number.
Format: (000) 000-0000.
Email Address (for confirmation):
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example@example.com
Residential Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Section #2: Eligibility Criteria
Please select all that apply. Proof may be requested upon approval.
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We receive CalFresh (SNAP), Medi-Cal, or TANF benefits (Temporary Assistance for Needy Families)
We are enrolled in the Section 8 Housing Voucher Program
Our total household income is at or below $52,600
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Section #3: Documentation Upload
Please upload proof of Eligibility.
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Section #4: Consent & Certification
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I certify that the information provided is true and accurate to the best of my knowledge. I understand that submitting this application does not guarantee free swim admission and that eligibility will be confirmed by City of El Centro staff.
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I understand that if awarded, this scholarship is non-transferable and cannot be exchanged or replaced for other programs or individuals.
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I acknowledge that applications are reviewed on a first-come, first-served basis contingent upon the availability of funding.
Signature
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Date
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Month
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Day
Year
Date
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