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Parks and Recreation Fee Assistance Application

Sections

The Parks and Recreation Department provides high-quality recreation opportunities in Bloomington, Minnesota. We offer low-cost programs and services that benefit physical, mental, social, and emotional health. Fee Assistance is available for people who live in Bloomington. You must show a financial need to receive fee assistance for eligible programs and services.

To be considered for fee assistance, please complete and submit the form below. If you have questions or need more information, contact: 

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INSTRUCTIONS

  • Provide full information for ALL people living in the household, including the Main Contact listed above. 
  • Main Contact should input "self" in the Relationship field. 
  • Grades (input the following for each household member): 
    • P = Children not yet in school
    • K = Kindergarten
    • 1-12 = 1st through 12th grade
    • 13 = Post high school / Adults
  • Click the "ADD" button for more entries. 
Name Birth Date Grade (next fall) Relationship to Main Contact Person Weight
more items
LIST A

 

  • If you select ONE from this list, you do not need to select any from List B or C. 
LIST B
(SNAP or Medical Assistance)
(Disability or Supplemental; Retirement Benefits do not qualify)

 

  • Select ONE from this list and ONE from List C.
LIST C

 

  • Select ONE from this list and ONE from List B.
Click here to upload your supporting file(s). Almost any file type can be uploaded (see list below), but PDF, JPG and PNG are preferred. 
Unlimited number of files can be uploaded to this field.
100 MB limit.
Allowed types: gif jpg png bmp eps tif pict psd txt rtf html odf pdf doc docx ppt pptx xls xlsx xml avi mov mp3 ogg wav bz2 dmg gz jar rar sit svg tar zip.
Input the total income of all members of the household combined. 
By typing your name in this field, you certify that all information provided is true, correct, and complete to the best of your knowledge and ability. You furthermore agree to abide by all policies, rules and procedures related to Fee Assistance from the City of Bloomington. 
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Please take notice that any data received by the City as the result of submitting this form will be classified as government data pursuant to the Minnesota Government Data Practices Act, Minnesota Statutes Chapter 13. Under the Data Practices Act, some or all of this data is classified as public data, including your name, address, email address, phone number, and other personal information provided by you. Public data is available to anyone requesting it and consists of all data furnished via this Web form. Please be advised that the correspondence will be added to the public record. The purpose and intended use of the information collected through this form is to obtain public input and data in support of City activities and services. You have the right to refuse to submit this form. If you choose not to submit this form, you will need to contact the City by another means if you wish to provide the information collected by the form.

The City of Bloomington does not discriminate against or deny the benefits of its services, programs, or activities to a qualified person because of a disability. To make a request for a reasonable accommodation, ask for more information, or to file a complaint, contact the Community Outreach and Engagement Division, City of Bloomington, 1800 West Old Shakopee Road, Bloomington, MN 55431- 3027; 952-563-8733, MN Relay 711.

Contact Information

Contact Information

Parks and Recreation Department

952-563-8877