Livingston Recreation & Pool Scholarship Application

Apply here for a scholarship for recreation programs, camps, and swimming lessons. Scholarships are funded by the City of Livingston for city residents, county residents will be considered if space allows. Please complete this form BEFORE REGISTRATION so that we may attach the correct scholarship to your CivicRec account.

After completing this form, you will receive emailed information about how to register for programs within 2 business days. Information provided will remain confidential. Questions or concerns? Use the box below, call 406-223-2233 or email rec@livingstonmontana.org.

Each participant in the household is eligible for (4) program/activity scholarships per fiscal year. (1) full camp is considered two program/activities due to pricing. The City of Livingston fiscal year runs July 1 - June 30.

If your household annual income is equal to or lesser than the Free/Reduced School Meal Application Table (provided below) you are eligible for up to 100% scholarship. If your household income is greater than the guidelines we will award scholarships on a sliding scale basis, awarding up to 75%, 50%, 25% support.

Person in Family / Household	Annual Income
1	$23,828
2	$32,227
3	$40,626
4	$49,025
5	$57,424
6	$65,823
7	$74,222
8	$82,621

* add $8,399 for each additional person beyond 8

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Parent or Guardian First Name *

Parent or Guardian Last Name *

Street Address *

City *

State *

Email *

ZipCode *

Phone *

Residency? *

Within 59047 zip code

In Park County, outside zip code area

Outside Park County

Please list participant names and birthdates. Members of your household only, please. List additional children in the box below.

Participant Name *

Birthdate

Participant Name

Birthdate

Participant Name

Birthdate

Participant Name

Birthdate

Additional children in household

First and last names, birthdates

Number in Family *

Head of household and dependents as defined on your federal income tax return.

Annual Income from All Sources *

As listed on your federal income tax return, including unemployment. Proof of income is not required at the time of application. By completing this form, you certify that you will provide proof of income if requested by City of Livingston financial auditors.

Program Requested *

List name of participant and specific class/program/activity you are seeking support for. Example: Jonny Smith, Age 3, Session 1 Preschool Swim Lessons, 10:20am, 11:00am or 4:00pm preferred.

Comments, Questions or Concerns?

By electronically signing this form, I certify the above information is accurate, and I agree my child/children will comply with program COVID-19 safety protocols. I further agree that while proof of income is not required at time of application, I will provide proof of income if requested by City of Livingston financial auditors.

Signature *

Livingston Recreation & Pool Scholarship Application

Contact Information

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