Scholarship Application

Friends of HEParks Scholarship Application

The Friends of HEParks Foundation provides access to families to participate in programs. Approval is based on the family’s circumstances and needs. Application Timeline: If approved, your application is valid for one year.

Each approved family will be assigned a percentage of support based on need, and will be limited to a maximum of $1000 per family per year ($250 per quarter). Once awarded, you will be responsible for your portion of payment at the time of registration (if not fully covered by scholarship).

Family members may not enroll in overlapping programs while supported by scholarship – scholarships are limited to one program per family member at a time.

Scholarship funding can be awarded for any program, event, fitness membership, or aquatic center membership. Please note that the scholarship will cover one week of Summer Camp per child. Additionally, some third party and independent contractor programs are not covered (ex. Hoffman Estates Redhawks Football and Cheerleading, Sport Mania Classes, Music Lessons, Private Lessons, Soccer Fundamentals).

To apply, complete the form below AND submit the following documents:

Driver’s Licence with current address, or current utility bill with name and address. AND,
One or more of the following options: Current SNAP award letter will all children and spouse (if applicable) listed on letter; Current school year Free Lunch Program letter; Current award letter from AllKids Healthcare program listing children; most recent Federal Tax Return with all children and spouse (if applicable) listed on the return.

If you need assistance with the application, please contact Cindy Flynn.

Today's Date(Requis)

Mois

Jour

Année

Application Information(Requis)

New Applicant

Subsequent Application

Is this your first application or have you applied for a scholarship previously?

Parent/Guardian Name(Requis)

Phone Number(Requis)

Alternate Phone Number

Adresse e-mail(Requis)

Parent/Guardian Date of Birth(Requis)

Mois

Jour

Année

Adresse(Requis)

Adresse postale Adresse Ligne 2 Ville État Code postal

Is address new since last registration?(Requis)

Yes

If yes, please provide past address

Marital Status(Requis)

Single

Married

Divorced

Separated

Widowed

1. Spouse/Partner Name (if applicable)

Premièrement Dernier

Birthdate

Mois

Jour

Année

Relationship to Applicant

2. Child's Name

Premièrement Dernier

Birthdate

Mois

Jour

Année

Grade

Relationship to Applicant

3. Child's Name

Premièrement Dernier

Birthdate

Mois

Jour

Année

Grade

Relationship to Applicant

4. Child's Name

Premièrement Dernier

Birthdate

Mois

Jour

Année

Grade

Relationship to Applicant

5. Child's Name

Premièrement Dernier

Birthdate

Mois

Jour

Année

Grade

Relationship to Applicant

6. Child's Name

Premièrement Dernier

Birthdate

Mois

Jour

Année

Grade

Relationship to Applicant

How many dependents (including yourself) live in your household?(Requis)

Please enter a number from 1 to 10.

Please list your current total household income:(Requis)

Please enter a number from 1 to 999999.

Which HEParks programs are you interested in?(Requis)

Please include the family member name, Program Name, Section Number, and Start Date. Use one line for each program.

Please upload a photo of a current Driver's License, State Issued ID, or current utility bill with name and address.(Requis)

Max. file size: 128 MB.

Please upload a copy of one of the following: Current SNAP award letter with all children and spouse (if applicable) listed on letter; OR current school year free lunch program letter; OR current coverage letter for AllKids Healthcare/Medicaid; OR most recent Federal Tax Return with all children and spouse (if applicable) listed on the return.(Requis)

Max. file size: 128 MB.

Consent(Requis)

I fully understand that the financial and extenuating circumstances outlined above will be kept confidential by the Hoffman Estates Park District. The above information is true and accurate to the best of my knowledge. Any incorrect information will automatically disqualify me from this program and will require me to reimburse the Hoffman Estates Park District for any past payments. I understand that it is my responsibility and obligation to notify the Park District of any changes in financial status. By submitting this application, I also consent to the Hoffman Estates Park District Waiver and Release of All Claims and Assumption of Risk.

Waiver and Release of All Claims and Assumption of Risk Please read this form carefully and be aware that in signing up and participating in the Hoffman Estates Park District identified programs/activities, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with said programs/activities (including transportation services/vehicle operation, when provided.)
I recognize and acknowledge that there are certain risks of physical injury to participants in these programs/activities and I voluntarily agree to assume the full risk of any injuries, damages or loss regardless of severity that I or my minor child/ward may sustain as a result of participation. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in these programs/activities against the Hoffman Estates Park District, including its officials, agents, volunteers and employees (hereinafter collectively referred as Hoffman Estates Park District.)
I do hereby fully release and forever discharge the Hoffman Estates Park District from any and all claims for injuries, damages, or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with these programs.
Important Information The Hoffman Estates Park District is committed to conducting its recreation programs and activities in a safe manner and holds the safety of participants in high regard. The Hoffman Estates Park District continually strives to reduce such risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/guardians of minors registering for this program/activity must recognize that there is an inherent risk of injury when choosing to participate in recreational activities. You are solely responsible for determining if you or your minor child/ward are physically fit and or skilled for the activities contemplated by this agreement. It is always advisable, especially if the participant is pregnant, disabled in any way or recently suffered an illness, injury or impairment, to consult a physician before undertaking any physical activity.
Warning of Risk Recreational activities/programs are intended to challenge and engage the physical, mental and emotional resources of each participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury when participating in any recreational activity/program. Understandably, not all hazards and dangers can be foreseen. Participants must understand that certain risks, dangers and injuries due to acts of God, inclement weather, slipping, falling, equipment failures, failure in supervision, premises defects and all other circumstances inherent to recreational activities /programs exist. In this regard, it must be recognized that it is impossible for the HE Parks to guarantee absolute safety.
Ice-skating/Hockey is intended to challenge and engage the physical, mental and emotional resources of the participant. Despite careful and proper preparation, instruction, medical advice, conditioning and equipment, there is still a risk of serious injury, including but not limited to head injury, neck or back injury, wrist and ankle fractures, and other orthopedic injuries to limbs and joints. All hazards and dangers cannot be foreseen. The very nature of ice- skating/Hockey is high risk, including but not limited to slip and falls, colliding with other players of varying degrees of skill (including being struck from behind), tripping on irregular ice surfaces, cuts from skate blades, inadequate or defective equipment, ill-fitting skates, failure in supervision or instruction, horseplay, carelessness, poor technique, poor conditioning, rule violations, striking a stationary object, premises defects outside the rink, and all other risks inherent to the sport of ice-skating. In this regard, it must be recognized that it is impossible for the Hoffman Estates Park District to guarantee absolute safety.
Communication & Marketing Release I, or my child, as a participant in a Hoffman Estates Park District program or event when using one of its public parks or facilities, may be photographed or videotaped by the Hoffman Estates Park District (HE Parks) or its assigns and transferees. I grant permission to HE Parks to copyright, use and publish the same in print and/or electronically with or without my name and for any lawful purpose, including for example, publicity, illustration, advertising, program guide, brochures, newsletter, email, digital media boards, website, social media, news releases or other promotional materials.