Survival Swim Lesson Scholarship Application 2021

Please read the requirements below before proceeding.
If you do not meet the elgibility requirements for a scholarship, please contact the swim school directly for lesson information. 
 
1.  New students must be between the age of 12 months and 5 years old.
 
2.  Students are required to contribute $10 per week towards tuition directly to their instructor.
     Water Smart Tots covers up to 90% of the total lesson tuition but does not cover any registration fees required by the instructor or swim program. 
 
3.  Applicants must be able to provide proof of currently receiving one or more of the following forms of  government assistance:
          SNAP/Food Stamps Benefit
          Gold Card Medicaid *
                   *Florida Healthy Kids and Share of Cost Health Insurance does not qualify at this time.
 
4.  Proof must include all pages of recent "Notice of Case Action" issued from the Florida Department of Children and Families dated within 30 days of your application. If you are applying for a foster child, you must provide current or recent Court Order of Legal Guardianship. 
 
5.  If awarded, child must be able to attend lessons daily for the entire 3-6 week course.
 
6.  Funds for a scholarship are available on a first come first serve basis. Once the allocated funds are depleted, the scholarship appliction will close pending additional funding from private donors.
 
Please allow 5-7 business days for your application to be reviewed. Incomplete applications will not be reviewed. You will be notified of the status of your application via the email address you provide.  

1st Child Information

Is this a foster child? *
 +
Please choose which form of government assistance this child currently receives. You will be asked to upload all pages of of your "Notice of Case Action" which can be found on your Access Florida Account. Documents must current. If child is a foster child, you must provide court order of legal guardianship. *
Will you be applying for another child? *

2nd Child Information

Is this a foster child?
 +
Please choose which form of government assistance this child currently receives. You will be asked to upload all pages of of your "Notice of Case Action" which can be found on your Access Florida Account. Documents must current. If you are applying for a foster child, you must upload court order of legal guardianship. *

Parent/Guardian Information


Lesson Location and Information

*Water Smart Tots does not have any control with each individual instructors' schedule.  The instructors' schedules tend to fill up very quickly.  It is not unusual for instructors to have a long wait list during peak season.  In the event you decide to be withdrawn from the instructor's wait list, it is required that you give both Water Smart Tots AND the instructor proper notification.  

REQUIRED DOCUMENTS


Release of Liability

Photo/Video Release
I give permission to WATER SMART TOTS, INC. and its partnered instructors to record and utilize photographs of me and/or my minor child(ren) on videotape, audiotape, photograph or any other medium in all forms of advertising, trade and any other lawful purposes including but not limited to: print advertising, photographs, video, website, and social media.
 *
Assumption of Risk
I understand, agree and acknowledge that there are risks inherent in sports activities conducted by WATER SMART TOTS’ partnered swim instructors. These activities may be of a hazardous nature and/or may include swimming, diving and a variety of strenuous exercise and physical activities. With the full understanding of the facts, I state that to the best of my knowledge, the participants I am registering have no medical, physical, or emotional conditions which would hinder or prevent safe participation in WATER SMART TOTS’ partnered swim instructors.
 *
Release of Liability
I release and hold harmless WATER SMART TOTS, INC., its officers, board members,  volunteers, and partnered swim instructors or swim locations and its owners or affiliates from any and all liability, claims, demands, and causes of action whatsoever, arising out of or related to any loss, damage, or injury, including death, that may be sustained by the participants and/or the undersigned, while in or upon the premises or any premises under the control and supervision of WATER SMART TOTS, INC., its officers, board members, operators, partnered swim instructors, volunteers, pool hosts, or in route to or from any of said premises.  I also acknowledge that enrollment, participation in or completion of lessons in no way implies that the participants are drown proof or water safe and that as the parent or legal guardian of the participants, I am ultimately responsible for my child's safety in or around water and must at all times ensure appropriate, vigilant and persistent supervision. *
Enrollment Review and Payment Policy
I understand that I am being awarded a scholarship for survival or self-rescue swimming skills taught by specialized survival swimming instructors who have partnered with WATER SMART TOTS, Inc. to provide such services and that this scholarship may be revoked at any time at the discretion of WATER SMART TOTS, INC. I also understand that this scholarship for survival swim lessons is being awarded to my child/ren with the understanding I must commit to arriving to lessons each day and on time and strictly adhere to ALL guidelines and protocols of each instructor. I certify that all medical/health information I have provided is correct and true and will update my child’s instructor should there be any medical changes during the time my child is enrolled in lessons. I agree to provide additional information including a physician's clearance if requested, prior to the beginning of any lessons. *
QUESTIONS?  Email wstscholarships@gmail.com