Fee Assistance Application

Fee Assistance Application

Fee assistance is available to City of St. Petersburg residents who meet the income eligibility guidelines as provided by the Florida Department of Health.

Income Eligibility Guidelines

Effective from July 1, 2025, to June 30, 2026

* Add amount for each additional family member.

Center/Pool*
Scholarships are available for Boyd Hill Nature Preserve customers who reside outside St. Petersburg city limits and meet the income eligibility criteria. To be considered, please complete this form.
Which camps are you requesting scholarship funding for?*

Fall CampWinter CampSpring CampSummer Camp
Parent/Guardian
Parent or Guardian's Legal Name*

First NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Address*

Street Address

Street Address 2 - Apartment or Unit Number

CityState

Zip Code
Email*
example@example.com
Home Phone Number*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Participant
Child's Legal Name*

First NameMiddle NameLast NameSuffix
Date of Birth*

MonthDayYear
Grade*
Household Information

Household Members - All adults and children residing in the household must be listed.*

	First Name	Last Name	Annual Income	Relationship to Parent/Guardian
Parent/Guardian
Participant
Additional Family Member
Additional Family Member
Additional Family Member
Additional Family Member
Additional Family Member

Total Household Annual Income*
Total Household Members*
Eligibility Documentation*

Free/Reduced Lunch Approval LetterMedicaid Income Eligibility LetterWomen, Infants, and Children (WIC) Income Eligibility LetterPrevious Year's Tax Return
Please upload current eligibility documentation. ALL SOCIAL SECURITY AND ACCOUNT NUMBERS MUST BE REDACTED OR REMOVED ON ALL FORMS BEFORE UPLOADING.*

Cancelof
Government Issued ID (i.e. Driver's License)*

Cancelof
Comments
I certify that all of the above information is true and correct, and that all income is reported. I understand that this information is given for subsidized childcare; that city officials may verify the information on the application; and that deliberate misrepresentation of the information will result in repayment at the full price rate.

By typing my name below, I understand and agree that this form of electronic signature has the same legal force and effect as a manual signature.
Signature
Should be Empty:

Parent/Guardian