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2023-2024 RAP Scholarship Application

RAP SCHOLARSHIP DEADLINE: SUNDAY, JULY 30, 2023 12:00 AM

The City of Santa Barbara Parks and Recreation Department offers scholarships for the Recreation Afterschool Program (RAP). Please note that scholarship funds are limited and provided on a first come, first served basis; and are based on income eligibility. PLEASE NOTE: submitting a scholarship application does not guarantee a scholarship.

STEP 1- Do you have a PerfectMind Account with Parks and Recreation? Is your medical information updated?

If you said YES to both, go to STEP 2.
If you said NO to either question, please create or log in to your account and amend your child’s medical information. log-in to your account here. Need help amending your child's medical information? click here for instructions.

Step 2- Complete this Scholarship Application and upload a photo of the first page of your 2022 Income Tax Return (1040 Form) along with 2 of your most current pay stubs.

Families interested in having their scholarship application reviewed before the start of school, must submitted their application by Sunday, July 30 by 12:00 am. Notification regarding scholarship awards will be provided via email by August 14^th.

Scholarship applications submitted after Sunday, July 30, will be reviewed in September.

Phone Number

Are any of your children going into kindergarten?

Yes

PLEASE NOTE: The RAP Program is for children entering in 1st-6th grade ONLY.

Participant Name & Grade

First Name *

Last Name *

Grade (2023-2024 school year) *

Participant Name & Grade

First Name

Last Name

Grade (2023-2024 school year)

Participant Name & Grade

First Name

Last Name

Grade (2022-2023 school year)

School

Have you received a RAP scholarship in past years?

Yes

Do you receive assistance from any of the following?

CalFRESH

Free or Reduced lunch

Medi-Cal

SSI (Supplemental Security Income)

Transition House

Welfare

WIC (Women, Infants, and Children Nutrition Services)

Other

Are you a single parent household?

Yes

Please note: all adults in the immidiate family, must provide proof of income.

How many adults are in your immediate family?

How many children are in your immediate family?

Documents you will need to apply for a RAP scholarship:

1040 form from 2022
2 most recent paycheck stubs

What is your total ANNUAL income? (No commas or periods) For example, if you make 31,012.42 a year, enter the amount as 31012

Take a photo 1040 Form and upload here

Click Here to Upload

Take a photo of your 2 most recent paycheck stubs and upload here:

Click Here to Upload

I understand that I will be notified about my scholarship through email ONLY. If I don't accept my scholarship by Monday, August 14 by 4:00pm, my scholarship will be given to the next person on the waitlist.

Yes, I understand.

I understand that my child may not attend the RAP program, unless my child's Medical Information is updated in Perfect Mind.

Yes, I understand.

Need help amending your child's medical information? Click here for instructions.

If you have already updated your child's medical information, then you don't need to do it again. Medical information is required to be updated once a year.

I understand to maintain my scholarship for the entire school year, I must use the program on a full-time basis and follow all RAP program rules and policies.

Yes, I understand.

Is there any additional information you would like to share regarding your scholarship request?

Sign Here

First Name

Last Name

Choose how to sign

Draw Type

CITY OF SANTA BARBARA PARKS AND RECREATION PROGRAM/ACTIVITY LIABILITY WAIVER, RELEASE AND ASSUMPTION OF RISK AGREEMENT This liability waiver, release, and assumption of risk agreement is intended to protect the City of Santa Barbara from lawsuits arising from its Park and Recreation Programs or Activities. It is an important document that affects the legal rights of participants in City Parks and Recreation Programs or Activities. Applicable to Participant listed above (“Participant”) RAP Program (“Program”) AGREEMENTS: 1. WAIVER OF RIGHT TO SUE. Participant, or Participant’s parent or legal guardian if Participant is a minor, waives the right and agrees not to sue the City of Santa Barbara for any injury, illness, or death arising from Participant’s participation in the Program regardless whether caused by any negligent act or omission of the City. 2. INDEMNIFICATION AND HOLD HARMLESS. Participant, or Participant’s parent or legal guardian if Participant is a minor, agrees to indemnify and hold harmless City from claims or damages for any third party injury, illness, or death arising from Participant’s participation in the Program, except those arising from a negligent act or omission of the City. 3. VOLUNTARY ASSUMPTION OF THE RISK. Participant, or participant’s parent or legal guardian if Participant is a minor, is fully informed about the Program and its activities voluntarily agrees to assume the risk of injury, illness, or death of Participant, or damage or loss of Participant’s property arising from Participant’s participation in the Program. 4. SCOPE OF AGREEMENT. Participant, or Participant’s parent or legal guardian if Participant is a minor, agrees that this Agreement is intended to be as broad and inclusive as permitted by California law and that if any portion thereof be held invalid, notwithstanding, the balance shall continue in full legal force and effect. As used in this Agreement, “City” means the City of Santa Barbara and its officers, employees, contractors, and agents. As used in this Agreement, Participant, means the Participant named above and the Participant’s heirs, beneficiaries, legal representatives, successors, assigns, and any person claiming a legal right by or on behalf of Participant. ACKNOWLEDGMENT AND EXECUTION. By signing this agreement, or electronically checking a box or clicking an accept button, Participant, or Participant’s parent or legal guardian is Participant is a minor, agrees to all of its terms and that there are no other agreements modifying or limiting its terms. If Participant is a minor, the person executing this agreement warrants that the person is the Participant’s custodial parent or legal guardian acting on behalf of the Participant.