Registration Form (HUP)

Registration Form

Homeschool Umbrella Program
Parent Information
Father/Guardian*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Email*
example@example.com
Mother/Guardian*

First NameLast Name
Cell Phone*
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Email*
example@example.com
Student Application Information
Applicants Full Name*

First NameMiddle NameLast Name
Date of Birth*

MonthDayYear
Date
Gender*
Entering Grade*
2023-24 School Year
Number of years homeschooled*
Previous School Attended
Services Requested
Elective Classes (Grades 6-12)

ArtDramaBandCadets (Grades 7-12 only)Life Skill (Grades 6-8 only)Strength and Conditioning (Grades 9-12 only)
Athletics Participation (Grades 6-12)

Girls VolleyballGirls BasketballGirls SoftballCo-Ed SoccerCo-Ed Cross CountryBoys BasketballBoys FootballTennisTrack and Field
$1,200 per class/per year $175 Sports Fee

Registration Fee -$100.00/student
Signature*

Clear
Date*

MonthDayYear
Date
Once completed, please send check to:
Family Christian Academy
Attn: Homeschool Umbrella Program
20035 Quesada Ave.
Port Charlotte, FL 33952
Should be Empty:

Registration Form