FCA Surf

Number of children from your family planning to attend camp

Campers First Name:

Campers Last Name:

Street Address:

City:

State:

Zip Code:

Camper Email:

Camper Cell Phone:

Parent/Guardian Name:

Parent/Guardian Email:

Parent/Guardian Cell Phone:

Current School:

Grade(s) (as of September 1, 2023)

Age(s) (as of June 17th, 2024)

What camp(s) are you interested in attending?

Surf Camp Ocean City

Surf Camp Beginner Week Ocean City

Skate Camp Ocean City

Surf Monmouth County

Have you attended an FCA Surf or Skate Camp in the past?

If yes, which one (s)?

Surf Camp

Beginner Surf Camp

Skate Camp

Have you received an FCA scholarship before? If so, what year(s)?

Parents combined gross income for previous year: (Please check appropriate box)

What scholarship amount do you feel you need in order to attend camp?

Do you have an FCA Huddle at your school?

If so, are you actively involved?

Other Siblings and ages:

Do you currently attend a church?

If yes, what church do you attend?

Additional comments:

PO Box 98

Moorestown, NJ 08057

609-545-7742

kharvey@fca.org