Mounds View Community Education- Youth Financial Assistance/Scholarship Request Form
Please complete the form below to be considered for financial assistant/scholarship for a  Youth Community Education Program.  To be considered for financial assistance you must  live in Mounds View School District or be open enrolled.

Our Community Education team processes financial assistance/scholarship request Form on Mondays and  Thursdays.

There are 2 ways to qualify for Financial assistance:
1.  Your student has applied and is currently receiving Free and/or reduced lunch.
2.  Request a scholarship due to special circumstances.

Please note financial assistant is not available for all programs, please call 651-621-6020 to verify availability.

Our Community Education team processes financial assistance/scholarship request Form on Mondays and  Thursdays. Once your form is submitted a member of the Community Education team will notify you via email if it has been approved and help you complete registration for the students program.

Please note:  If you are approved we are able to offer one 50% scholarship per student per season, (Sumner, Spring/Winter, Fall)

Please call 651-621-6020 with any questions.


Bey completing this form you are agreeing to the following:

HOLD HARMLESS AGREEMENT MOUNDS VIEW PUBLIC SCHOOLS                                                                                         In consideration of my participation or my child’s in a program at Mounds View School District (“the District”), I “the Participant” and  Parent/Guardian if Participant is under 18 years old, hereby agree for the the District shall not be liable for any damages arising from personal injury or property damages sustained by me in, on, or about the District premises resulting from or arising out of the participation and/or use or intended use of the District facilities or equipment. I agree to assume full responsibility for any injuries which may occur to me in or about the District’s premises, or while using or intending to use the District’s equipment, including, but without limitation, any claims for personal injury or property damage resulting from or arising out of the negligence of the District, its agents or employees, or the negligence of any other persons present on the District’s premises. I also understand that there is an inherent risk                                                                                                               ASSUMPTION OF RISK, RELEASE AND WAIVER OF LIABILITY AGREEMENT RELATING TO COVID-19 EXPOSURE, COVID-19 LIABILITY, AND COVID-19 RISK In CONSIDERATION for myself and/or my children listed below being permitted to utilize the facilities of the Mounds View Public Schools and the Community Education Department.The undersigned acknowledges that they have reviewed and agree to the conditions of Mounds View Public Schools Reopening Plan (https://www.moundsviewschools.org/reopeningplan) and the MN Department of Health Covid guidelines.The undersigned acknowledges and agrees that Mounds View Public Schools has taken certain steps to implement certain recommended guidance and recommendations issued by public health agencies for slowing the transmission of COVID-19, including those listed above.. The undersigned fully understands and appreciates both the known and potential dangers of participating in the programs and/or utilizing the facilities and acknowledges that use thereof by the undersigned and/or such participating children and/or adults may,despite the District’s reasonable efforts to mitigate such dangers, result in exposure toCOVID-19, which could result in quarantine requirements, serious illness, disability, and/or death.THEREFORE, THE UNDERSIGNED HEREBY ASSUMES FULL RESPONSIBILITY FOR,AND RISK OF ILLNESS, BODILY INJURY, OR DEATH AND WILL HOLD HARMLESS AND RELEASE AND WAIVE ANY CLAIMS AGAINST Mounds View Public Schools or any of their respective employees, volunteers and agents, from any loss, liability, damages or costs they may incur, whether caused by negligence, active or passive, or otherwise while the undersigned or any participating child is participating in any program offered during the summer of 2020 by the Mounds View Community Education Department.I HAVE CAREFULLY READ AND VOLUNTARILY SIGN THIS ASSUMPTION OF RISK,RELEASE AND WAIVER OF LIABILITY. I AM AWARE THAT BY AGREEING TO THIS AGREEMENT I AM GIVING UP VALUABLE LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES IN CASE OF ILLNESS, INJURY, DEATH FROM EXPOSURE TO COVID-19 AT ANY DISTRICT FACILITY OR DURING PARTICIPATION IN ANY PROGRAM. I ALSO UNDERSTAND THAT THIS AGREEMENT IS MADE ON BE HALF OF MY MINOR CHILD(REN) AND/OR LEGAL WARDS.Questions? Please contact Community Education at 651-621-6020


Sign in to Google to save your progress. Learn more
Untitled Title
Student's name: *
Student's School: *
Students Classroom/Homeroom Teacher: *
Student's Current Grade *
Parent/Guardian Name: *
Parent/Guardian Email: *
Home Phone: *
Parent/Guardian Work/Cell Phone: *
Street Address: *
City: *
Zip *
Please list the title of the class/activity the youth participant would like to attend:   *
What is the Course/Activity code?               Example  S19-orch-6ch *
Activity codes can be found in Community Ed catalogs or online at https://moundsview.ce.eleyo.com
Does this youth participant qualify for Free/Reduced Lunch? *
If you are requesting financial aid due to a special circumstance please indicate needs below:
This participant will: *
Before school session only:  Will the participant eat breakfast after this activity?
Clear selection
Any addition participant information (Medical, allergy, accommodation needs, Etc)
By typing your name below you are confirming that the information you provided is true and correct to the best of your ability. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mounds View Public Schools. Report Abuse