Experience FC January '27

Student Information

First Name

Last Name

Birthdate

Gender

Select your current grade level in high school

Expected College Entry Term

Student Phone Number*

Email Address

Mailing Address

Country

Street

City

Region

Postal Code

Where did you hear about Florida College?

Please select your primary Florida College Camp

Please select what majors or degree programs you are interested in. (Check all that apply) *

Will this be your first visit to our campus? *

T-Shirt Size *

Will you be accompanied by a parent/guardian? *

Parent/Guardian Information

Students attending Experience FC must be accompanied by a parent/legal guardian or a chaperone. A current Florida College student cannot be used as a chaperone.

Parent/Guardian Name (First) *

Parent/Guardian Name (Last) *

Parent/Guardian Phone Number *

Parent/Guardian Email *

Parent/Guardian's Relationship to Student *

Students attending Experience FC must be accompanied by a parent/legal guardian or a chaperone. A current Florida College student cannot be used as a chaperone.

Will you be accompanied by a chaperone?*

Chaperone 1 Name (Frist) *

Chaperone 1 Name (Last) *

Chaperone 1 Email (Primary email address for Chaperone 1) *

Chaperone 1 Phone (Primary contact for Chaperone 1) *

Relationship to Student (What is this chaperone’s relationship to the student attending?) *

Additional Guests

How many additional guests are you bringing? *

Guest 1 First Name

Guest 1 Last Name

Guest 2 First Name

Guest 2 Last Name

Guest 3 First Name

Guest 3 Last Name

Total Event Fee

Amount Due
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Amount Due

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I hereby grant Florida College permission to interview me and/or to use my likeness in photographs/video/audio in any and all of its publications and in any and all other media, whether now known or hereafter existing, controlled by Florida College, in perpetuity, and for other use by Florida College. I will make no monetary or other claim against Florida College for the use of the interview and/or the photographs/video/audio. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. *

Yes