Child Tuition Waiver Form Camp or Class 1st choice: * Camp or Class 2nd choice: * Student Name * First Name Last Name Student Age * Student Birth Date * MM DD YYYY Parent or Guardian name: * First Name Last Name Address Address 1 Address 2 City State/Province Zip/Postal Code Country Primary Phone * (###) ### #### Another Phone (###) ### #### Parent/Guardian Email * Do parents reside in the same household? * Yes No Marital status * Married Divorced Separated Single Number in household (Adults and Children): * Does your family qualify for the Federal Free School Lunch Program? * Yes No Yearly Family Income: * Adjusted Gross Income: * Special financial considerations (please describe): What percentage of tuition reduction are you requesting? * * Tuition wavers require a 10% registration fee 100% 75% 50% 25% Could you contribute to your child's or teen's tuition in other ways? * Volunteer Supplies Other (describe below) Proof of income is required - I have emailed a copy to admin@baddogarts.org * Most Current Tax Return Current W2 DWS Financial Benefit Statement Employer Verification Statement House Authority Annual Income Form Other (please specify below) I understand that all information I provide is private and confidential. By my signature below, I acknowledge that all of the above information is accurate and true. * Parent or Legal Guardian Signature Date * MM DD YYYY Thank you!
