Name
Parent/Guardian Name
Address
BCA is committed to removing financial barriers to participation for all and to reserving significant financial assistance to support our most vulnerable citizens. If you are requesting financial assistance, please select the amount below.
Check this box if you can almost fit this program into your budget but need a little help.
Check this box if you are doing OK financially but live within a strict budget.
Check this box if you are struggling financially but living paycheck to paycheck.
Check this box if you qualify for any of the following programs: BED Energy Assistance; Vermont Seasonal Fuel Assistance; 3SquaresVT; VGS Energy Assistance; Vermont Section 8 Assistance.
Photo Release: I grant permission for the City of Burlington or its agents to photograph or record my child's image or voice, during programs and activities, without payment or consideration. I understand that any such photographs or recordings will become the property of the City of Burlington. By selecting this box I am agreeing to the above. Additional details can be found in the Assumption of Risk and Waiver of Liability.
Artwork Release: I grant permission for the City of Burlington or its agents to photograph or reproduce images of my child's artwork, during programs and activities, without payment or consideration. I understand that any such photographs or recordings will become the property of the City of Burlington. By selecting this box I am agreeing to the above. Additional details can be found in the Assumption of Risk and Waiver of Liability.
I grant my child permission to leave the premises for the following situations. Check all that apply. NOTE: Chaperoned walking field trips such as guided photo walks, painting en plein air, etc. are included in some program curriculum. If you do not grant permission for your child to leave on their own they must enroll in Lunch Coverage as applicable.
Please share more information about your child's medical background, including allergens, dietary restrictions, living with a disability, etc. Check all that apply.
Will your camper be bringing medication that needs to be administered during camp? If yes, you will be asked to upload the BCA Medication Administration Form document to your Civic Rec account below before camp starts.
Will you be needing LUNCH coverage (11am-12pm) at the BCA Studios? Lunch coverage is available for a fee of $60/week. NOTE: All campers enrolled in a morning and afternoon camp will need to enroll in lunch coverage for that week. Morning campers (8-11am) are welcome to add lunch coverage; lunch coverage is not available for campers only enrolled in an afternoon camp
Will you be needing AFTERCARE coverage (3-5pm)? Aftercare is available for a fee of $120/week; it features sketch book time, visits to local hot spots, and other fun art activities. More time to explore and make! NOTE: Aftercare is available for campers enrolled in full-day and afternoon camps only.

Please tell us more about the scholarship recipient and your household! We are committed to creating a diverse and inclusive organization. The following section is optional, but your information will help us greatly in developing future programs and events. Thank you! Your privacy matters to us. Your information will never be shared or sold.

Age
Gender
Do you work in the city of Burlington?
Protected Classes (Select all that apply)
Race/Ethnicity (Select all that apply)

BCA’s Education Director is usually able to process scholarship applications in a week’s time (or less) and will be back in touch. Questions? Contact BCA Education Director Melissa Steady: msteady@burlingtoncityarts.org