Girls Rock! Camp 2017 Application
Thank you in advance for taking the time to complete the camper application. Please know that all of the information you provide contributes greatly to our efforts to make rock camp a supportive and fun environment for everyone. We appreciate your participation in that effort! There's lots more information about camp, and about this application process on the Girls Rock! Camp Info Sheet, which is available at the same place on our website where you found this form! http://williemaerockcamp.org/programs-page/girls-rock-camp/

Applying to Girls Rock! Camp is a 1-3 part process.

Part 1: Filling out this form! (This is your only step, RETURNING CAMPERS! Notifications sent on Thursdays)

NEW PARTICIPANTS ONLY:
Part 2: Submitting an "Express Yourself" piece (information in section)
Part 3 (optional): Community Award Application, please be sure to check out the Community Awards info sheet on the same page of our website where you found this link!

We will only consider applications that are complete. If you have any questions, please call 347-599-0716 or e-mail info@williemaerockcamp.org.

Si deseas una solicitud en español, por favor escribe a info@williemaerockcamp.org o llama a 347-599-0716.

Girls Rock! Camp Session One will take place from July 24th to July 29th, 2017
Girls Rock! Camp Session Two will take place from August 7th to August 12th, 2017

Email address *
Camp Session *
Please indicate which camp session you are applying for
Are you interested in the other session if your first choice is unavailable? *
ABOUT THE CAMPER
Camper's First Name *
Your answer
Camper's Last Name *
Your answer
First Name as you would like it to appear on camper badge
If different from legal name
Your answer
Camper's Email Address
If applicable
Your answer
Camper's Date of Birth *
MM
/
DD
/
YYYY
Camper's Age *
At time of camp
Your answer
Camper's Preferred Gender Pronouns
Preferred Gender Pronouns, or PGPs, are the pronouns that an individual would like other to use when talking to, or about, that individual. Check all that apply.
Name of Camper's School *
Your answer
Current Grade in School
If the camper is currently enrolled in school...
Your answer
This school is *
Camper's Primary Address *
Your answer
City *
Your answer
State *
Your answer
Zipcode *
Your answer
Camper's Mailing Address
If different than above
Your answer
Mailing City
If different than above
Your answer
Mailing State
If different than above
Your answer
Mailing Zipcode
If different than above
Your answer
CAREGIVER INFORMATION
Main Contact Name *
Your answer
Main Contact Email Address *
Your answer
Main Contact Primary Phone Number *
Your answer
Main Contact Alternate Phone Number
Your answer
Relationship to Camper *
Your answer
Does Main Contact live with the Camper? *
Main Contact Address
If different from camper's primary address
Your answer
Secondary Contact Name
Your answer
Secondary Contact Email Address
Your answer
Secondary Contact Primary Phone
Your answer
Secondary Contact Alternate Phone
Your answer
Relationship to Camper
Your answer
Does Secondary Contact live with the camper?
Secondary Contact Address
If different from camper's primary address
Your answer
Name of person filling out application if not a parent/guardian
Your answer
Relationship to Camper
Your answer
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