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Roseville Parks & Recreation Fee Assistance Application

  1. Please note:

    Program fee assistance is available to those demonstrating financial need. Because of limited scholarship funding, only Roseville residents are eligible to apply for fee assistance.

    Qualified applicants are eligible for assistance of up to 80% of the program fees (maximum, $100 per participant annually). Information provided will be treated confidentially and will be used only for eligibility determinations.

  2. Complete the form and submit, including uploaded copies of the participant's registration form and proof of Roseville residency.

    Your application form submission will be acknowledged within a week of receipt. We recommend you print out your submission for your records.

  3. YOUTH participant:
  4. Does the participant qualify for free or reduced lunch at school?
  5. ADULT participant:
  6. ALL PARTICIPANTS:
  7. Demographics

    The City of Roseville is committed to making our services available to all members of our community.We can only do that when we understand who is using them. to help us do that, please respond to the following demographic question. More than one box can be checked.

  8. Which racial group(s) does the participant identify with?*
  9. Does the participant have a sensory, physical or mental disability?*
  10. SUPPORTING DOCUMENTS
    • First ensure you have scanned a copy of the participant's registration form and your proof of Roseville residency (such as a copy of your driver's license.
    • Then, in the field below, click "Browse" to navigate your computer to those scanned documents and upload them to this application form.


  11. Leave This Blank:

  12. This field is not part of the form submission.