VOLUSIA COUNTY 2018 SUMMER CAMP IMPORTANT INFORMATION

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1 VOLUSIA COUNTY 2018 SUMMER CAMP IMPORTANT INFORMATION Summer Camp Scholarships are for June 4th through July 27th Scholarships are not awarded on a first-come, first-served basis Scholarships are awarded based on income, funding availability and camp site availability If funding is not available, you will be put on a waiting list until funds are available If your first choice for camp is not available, you will be notified of other available camps Scholarships do NOT cover 100% of the camp fees Scholarships only cover a portion of the weekly fees set by the camp A list of registration fees, weekly fees, and field trip fees is included in the Approved Summer Camp Site List attached to your application packet APPLICATIONS WILL BE ACCEPTED AT THE FOLLOWING LOCATIONS AND TIMES Date Location Time Monday, New Smyrna Beach Library March 26, S. Dixie Freeway, New Smyrna Beach 9:00am 6:30pm Tuesday, Deltona Regional Library April 3, Eustace Ave, Deltona 9:00am 6:00pm Wednesday, Midtown Cultural & Education Center April 11, George W. Engram Blvd., Daytona Beach 7:00am 6:00pm Thursday, TCK, County Admin Building April 19, W. Indiana Ave, DeLand 7:30am 6:00pm Applications will not be accepted if delivered in person or by mail before April 19, 2018 Faxed or incomplete applications will not be accepted Applications turned in after April 19, 2018 will be placed on a waiting list The County of Volusia may stop accepting applications without notice For additional information contact Jill Marcum at: (386) in DeLand, (386) in Daytona Beach, or (386) in New Smyrna Beach

2 County of Volusia Community Assistance 110 W. Rich Avenue, DeLand, FL (386) Summer Camp Scholarship Application Checklist The intent of this checklist is to determine whether your child is eligible for a summer camp scholarship. Applicant Name: Please answer the following questions. 1. Does your special needs child go to school and is grades one through 12? 2. Is your child at least five years old and no older than 12? 3. Is your child going into first (1 st ) grade through sixth (6 th ) grade? 4. Does your child live and go to school in Volusia County? 5. Is your annual gross household income at or below the maximum income limits for your household size? N/A If yes; skip to number 4 Household Size Maximum income $24,280 $32,920 $41,560 $50,200 $58,840 $67, Do you have your child s/children s most recent Report Card (dated within the past 6 months)? 7. Do you have proof of household/family size? You may use a SNAP award letter (dated within the past 90 days), most recent tax return, current lease, rental agreement or public housing verification letter that indicates the number in your household. 8. Do you have proof of income for all members of your household for the last 30 days? This may include: paystubs, TANF (cash assistance), child support (court documents), unemployment benefits and award letter, workers compensation, pension, and monetary help from family and friends. All sources of household income must be included. 9. If you are self-employed do you have last year s tax return along with a current year s profit and loss statement or a current year s work calendar? 10. If you are claiming $0 income, have you completed the Declaration of No Income Form? This form requires information on how you meet your basic needs and how you will pay for summer camp. 11. If you are claiming that your household income is only provided through family or friends, have you completed the Household Assistance Form? N/A N/A N/A APPLICATION IS ON NEXT PAGE included with your application if you claim $0 income included with your application if you claim income only through family or friends 12. Have you signed and dated your application? No Stop here; you must sign and date your application

3 2018 VOLUSIA COUNTY COMMUNITY ASSISTANCE SUMMER CAMP SCHOLARSHIP APPLICATION CHILD S INFORMATION Child s Name: Date of Birth: Age: Current School Child is attending Entering in to Grade: 1 st 2 nd 3 rd 4 th 5 th 6 th Other (special needs) SUMMER CAMP LOCATION: Please note that you CANNOT change camp sites after you have turned in your application. The list of providers, including weekly fees, is on the following pages. Type of Camp Selected: Volusia County Parks & Rec City Volusia County School EDEP (if selected you must fill out lunch information) Private Site Please write the full name of the camp being selected from the provided list: If attending a Volusia County School EPED site, please check if the applying child receives: Free Lunch Reduced Lunch Full Paid Lunch Please note that completing this information gives Volusia County Schools permission to provide the eligibility status of your child/children to the County of Volusia, Community Assistance Division. HOUSEHOLD INFORMATION Household Size: Number of Adults: Number of Children: How many adult household members are employed? CONTACT INFORMATION Parent or Guardian Name (s): Physical Address: Mailing Address, if different: Primary Contact Phone Number: Home Cell Work Secondary Contact Phone Number: Home Cell Work SIGNATURE AND INDEMNIFICATION The scholarship recipient shall hold harmless, defend and indemnify the COUNTY, officers, agents, and employees from, or on any account of, any and all claims, actions, lawsuits, losses, expenses, injuries, damages, judgments or liabilities of any kind whatsoever arising out of the summer camp program. Signature: Date: Child # Total # of Children The following to be complete by staff: Staff Initials - Gross Annual Household Size Application Income Guidelines Percentage Staff Initials - Calculation

4 2018 APPROVED SUMMER CAMP PROVIDER SITE LIST You CANNOT change camp sites after you have turned in your application. Scholarships cover an 8 week period from June 4th - July 27th. Please check with the camp as the number of weeks that camp is provided may vary. NORTHEAST SITES Volusia County Parks, Recreation and Culture Sites Holly Hill School Center Street, Holly Hill Palm Terrace Elementary Dunn Avenue, Daytona Beach R.J. Longstreet Elementary S. Peninsula Drive, Daytona Beach Turie T. Small Elementary South Street, Daytona Beach Blue Jay Academy - Special Needs Registration Fee: $25.00 Weekly Fee: $ Field Trip Fee: $0.00 South Daytona Campus Rooster Rd., South Daytona John H. Dickerson Center Club South Martin Luther King Blvd., Daytona Beach Rossmeyer Family Holly Hill Club Daytona Avenue, Holly Hill Chase Academy - Special Needs Registration Fee: $40.00 Weekly Fee: $ $ Field Trip Fee: $0.00 Chase Academy - Special Needs S. Ridgewood Avenue, #17, South Daytona City of Daytona Beach Registration Fee: $25.00 Weekly Fee: $30.00 Field Trip Fee: $ $15.00 Midtown Cultural & Educational Center George Engram Blvd., Daytona Beach Ortona Playground N. Halifax Avenue, Daytona Beach City of Ormond Beach - Summer Connections - Starts June 11, 2018 Weekly Fee: $68.00 Resident Registration Fee: $0.00 $ Non-resident Field Trip Fee: $0.00 South Ormond Neighborhood Center Division Avenue, Ormond Beach City of Ormond Beach - Camp T-Rec - Special Needs - Starts June 18 Registration Fee: $0.00 Weekly Fee: $82.00 Field Trip Fee: Camp T-Rec - Nova Community Center North Nova Road, Ormond Beach City of South Daytona Parks and Recreation Registration Fee: $11.00 Weekly Fee: $85.00 Field Trip Fee: $0.00 James Park Camp James Street, South Daytona Volusia County Schools - Extended Day Enrichment Program Registration Fee: $15.00 Weekly Fee: $80/$60/$50 Field Trip Fee: $10.00 Port Orange Elementary Dunlawton Avenue, Port Orange South Daytona Elementary Elizabeth Place, South Daytona Spruce Creek Elementary Taylor Road, Port Orange Pathways Elementary Airport Road, Ormond Beach 1

5 2018 APPROVED SUMMER CAMP PROVIDER SITE LIST You CANNOT change camp sites after you have turned in your application. Scholarships cover an 8 week period from June 4th - July 27th. Please check with the camp as the number of weeks that camp is provided may vary. NORTHEAST SITES CONTINUED Mt. Calvary Academy Registration Fee: $25.00 Weekly Fee: $64.00 Field Trip Fee: $0.00 Camp MCA Bellevue Avenue, Daytona Beach Reign Homeschooling Registration Fee: $45.00 Weekly Fee: $65.00 Field Trip Fee: $ Unknown Camp Destiny Granada Blvd., Ormond Beach Sankoffa University Registration Fee: $0.00 Weekly Fee: $59.50 Field Trip Fee: $ Unknown Sankoffa University - West Daytona Flomich Avneue, South Daytona Warner Christian Summer Camp Registration Fee: $35.00 Weekly Fee: $ Field Trip Fee: $ $20.00 Warner Christian Summer Camp S. Ridgewood Ave., South Daytona Holly Hill Family Daytona Avenue, Daytona Beach Ormond Beach Family Sterthaus Avenue, Ormond Beach Port Orange Family City Center Circle, Port Orange NORTHWEST SITES Volusia County Parks, Recreation and Culture Boy Scout Hut N. Frankfort Ave., DeLand Chisholm Center S. Clara Ave., DeLand DeLand High School Gym N. Hill Blvd., DeLand T.D. Taylor Middle/High School E. Washington Ave., Pierson Blue Jay Academy - Special Needs Registration Fee: $25.00 Weekly Fee: $ Field Trip Fee: $0.00 Blue Jay Academy - Special Needs S. Chandler Ave., DeLand Lacey Family Spring Hill Club S. Adelle Ave., DeLand Volusia County Schools - Extended Day Enrichment Program Registration Fee: $15.00 Weekly Fee: $80/$60/$50 Field Trip Fee: $10.00 George Marks Elementary N. Garfield Ave., Deland Woodward Avenue Elementary S. Woodward Ave., DeLand Power-Up Youth Enrichment Camp - Special Needs Registration Fee: $15.00 Weekly Fee: $75.00 Field Trip Fee: $5.00 Antioch Freewill Baptist - Special Needs W. Beresford Ave., DeLand 2

6 2018 APPROVED SUMMER CAMP PROVIDER SITE LIST You CANNOT change camp sites after you have turned in your application. Scholarships cover an 8 week period from June 4th - July 27th. Please check with the camp as the number of weeks that camp is provided may vary. NORTHWEST SITES CONTINUED Temple Learning Center Registration Fee: $15.00 Weekly Fee: $75.00 Field Trip Fee: $0.00 Temple Learning Center S. Adelle Ave., DeLand DeLand Family E. Inernational Speedway Blvd., DeLand SOUTHEAST SITES Volusia County Parks, Recreation and Culture Sites Edgewater Public School S. Old Country Road, Edgewater Mary DeWees Park N. Gaines Street, Oak Hill Coronado Beach Elementary Michigan Ave., New Smyrna Beach Edgewater Club N. Ridgewood Ave., Edgewater Oretha Bell Club Mary Ave., New Smyrna Beach Southeast Family W. Turgot Ave., Edgewater SOUTHWEST SITES Volusia County Parks, Recreation and Culture Sites Debary Hall Historic Site Sunrise Blvd., DeBary Gemini Springs - 37 Dirksen Dr., DeBary Orange City Elementary E. University Blvd., Orange City Harris Saxon Club California Street, Deltona Mid-Florida Jeep Lake Helen Club S. Lakeview Dr., Lake Helen Volusia County Schools - Extended Day Enrichment Program Registration Fee: $15.00 Weekly Fee: $80/$60/$50 Field Trip Fee: $10.00 Deltona Lakes Elementary Adelia Blvd., Deltona Osteen Elementary Doyle Road, Osteen Pride Elementary Learning Lane, Deltona Spirit Elementary Meadowlark Dr., Deltona Sunrise Elementary Phonetia Dr., Deltona Four Townes Family Wolf Pack Run, Deltona 3