Gross Out Camp Evaluation

Camper Name*

Camp Location*

Which week did you attend camp?*

Which additional week(s) did you attend camp?

Please rate Fresh Air Family's Gross Out Camp. *

Please rate our staff.*

Please describe your camper's experience.*

Please list 3 things you learned (for the campers)*

*

How can we make camp better?*

Member Information (important for fundraising!)

Are you a Fresh Air Family Member?*

Yes

No

How many events have you attended? *

Zip Code*

Ethnicity:

Caucasian

African-American

Latino or Hispanic-American

Native American/Alaska Native

Asian

Other

Do you have any disability? (please check all that apply)

Physical/affects ability to walk

Intellectual functioning (including diagnosed learning disability, brain injury, etc)

Behavioral and medical (ADHD, diagnosed depression, etc.)

Do you have any other comments, suggestions, or concerns?*

A Special thanks to our sponsors:

P.O. Box 130186 | Birmingham, AL 35213

Fresh Air Family is a nonprofit, 501(c)(3) organization. For more information, visit www.freshairfamily.org

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