FC Summer Camp 2023 1Summer Camp2Info3Summary HiddenSubmission ID HiddenDebug Is the Participant currently enrolled in perform care?* Yes No Click here to proceed to register for camp.Would you be willing to allocate your perform care funding to FC summer camp hours?* Yes No Click here to proceed to register for camp. InfoRegistration* Register a Participant Register a Sibling Applicant's InfoApplicant's Name* First Last Birth Date*MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberDay12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Age*Age*Applicant requires* Teen volunteer Trained adult aide – There will be an additional cost for the aid per program I will supply my own aide – no additional cost Name of Parent/Guardian* Parent/Guardian Email* Parent/Guardian Cell*Sign up for Summer CampRegister Participant for Camp:* FC Camp Week 1 Ages:3 - 20Dates:July 31 - August 3 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 FC Camp Week 2 Ages:3 - 20Dates:August 7 - August 10 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 FC Camp Week 3 Ages:3 - 20Dates:August 14 - August 17 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 Allies Summer Camp Ages:3 - 20 & 21+Dates:August 21 - August 24 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 Register Sibling for Camp:* FC Camp Week 1 Ages:3 - 20Dates:July 31 - August 3 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 FC Camp Week 2 Ages:3 - 20Dates:August 7 - August 10 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 FC Camp Week 3 Ages:3 - 20Dates:August 14 - August 17 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 Allies Summer Camp Ages:3 - 20 & 21+Dates:August 21 - August 24 Monday-Thursday: 9:30am-3:00pmFee: $320Registration Fee: $100 (non-refundable); applied to total costAide Fee: $840 HiddenDeposit_AmountHiddenTotal AmountForm CalculationsDeposit Amount Deposit AmountRemainderRecurring AmountTotalDepositRemainder After DepositHalf PaymentAid Fee: $840Aid Fee: $840Aid Fee: $840Aid Fee: $840Participant FC Camp - Week 1 Price: Participant FC Camp - Week 1 - QuantityParticipant FC Camp - Week 2 Price: Participant FC Camp - Week 2 - QuantityParticipant FC Camp - Week 3 Price: Participant FC Camp - Week 3 - QuantityParticipant Allie's Camp Price: Participant Allie's Camp - QuantitySibling FC Camp - Week 1 Price: Sibling FC Camp - Week 1 - QuantitySibling FC Camp - Week 2 Price: Sibling FC Camp - Week 2 - QuantitySibling FC Camp - Week 3 Price: Sibling FC Camp - Week 3 - QuantitySibling Allie's Camp Price: Sibling Allie's Camp - QuantityAid Fee- FC Camp - Week 1 Price: Aid Fee- FC Camp - Week 2 Price: Aid Fee- FC Camp - Week 3 Price: Aid Fee- Allie's Camp Price: Program Summary Total Payment{:273} Registration Fee $0.00 Balance $0.00 Total $0.00 Registration Amount Total $0.00 Total Charged Today Price: Total Charged Today$100.00Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country CommentsCommentsThis field is for validation purposes and should be left unchanged. 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