PLAYpass Application Form
Welcome to PLAYpass! To apply for $250 towards sports and recreation programs, please complete this form. To be eligible for PLAYpass, you must be a City of Boulder resident between the ages of 0 -17, and you must be able to provide proof of participation/eligibility in a federal, state, or local assistance program such as Free/reduced lunch, Medicaid, SNAP, WIC, Boulder Parks and Rec Financial Aid, etc.

Once we receive your submission, we will review your application and be in touch soon regarding next steps! Thanks for your interest in PLAYpass!

If you have questions, or need assistance completing this form, please email or call us at 720-791-2460.

Name of Participant *
Participant Gender *
Participant Date of Birth *
Participant Age *
Participant Grade *
Name of Parent/Guardian *
Phone Number *
Email Address *
I prefer to be contacted via *
Street Address *
City *
Zip Code *
Please indicate if you participate in any of the following assistance programs (please select all that apply) *
Please upload proof of participation in one of the assistance programs selected above (can be electronic copy of your Medicaid card, SNAP confirmation letter, etc. We will accept photos of any of these documents) *
Please tell us how you heard of PLAYpass *
I agree to share the above information with Boulder Parks and Recreation so I can receive Boulder Parks and Rec Financial Aid (50% off of all fee-based programs and activities). *
What is your race? (Select one or more responses) *
Please select the ethnicity you identify with most *
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