Youth Rock Camp 2020: Fall Virtual Registration
This registration form is for our first ever Virtual Youth Rock Camp (Formerly known as Girls Rock Camp) Fall Session 2020
10/13/2020 - 11/18/2020
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Instructions
Hello future rockers (and rocking parents/guardians)!

As you may know, we are still unable to offer in person programming in a way that would be safe for our participants, mentors and staff. With that, we are committed to offering an affirming space where girls, trans and nonbinary youth can have an outlet for musical expression and collaboration!


We're excited to announce that RIOT RI (fka Girls Rock!) will be hosting a 5 week virtual camp this Fall!

This registration form is for our first ever Virtual Youth Rock Camp (Formerly known as Girls Rock Camp) Fall Session 2020
10/13/2020 - 11/18/2020

Ages to join camp: 11 - 18 yrs old (must be in High School) This camp is only for youth who identify as girls, trans or nonbinary.

You will receive a detailed schedule once your registration has been confirmed, but you can expect the 5-week camp session to look something like this:

Tuesday 5:30 pm to 6:30 pm - community building - Instrument practice
Wednesday 5:30 pm to 6:30 pm - community building - Workshop
Thursday 5:30 pm to 6:30 pm community building - songwriting coaching session

Campers will receive instrument instruction, participate in a number of anti-racist workshops and songwriting sessions and collaborate with each other during the learning process. Campers will write an original song (instrumental or with lyrics) and get to perform it in a RIOT RI Virtual concert that will be livestreamed for friends, family, and fans through Facebook!

Tuition cost - $200 This includes use of an instrument** and learning package which will be delivered to you (delivery scheduling to follow)

** Instruments available for gear loan: Guitar Kit or Keyboard Kit. Note: f you have an instrument at home you feel super comfortable playing without much instruction, we are psyched to have you use it to write your original song, but know that for this camp we are only able to offer instruction for guitar and keyboards.

Tuition costs are subject to sliding scale based on the needs of your family, if you require financial aid please submit the proper info as instructed below and one of our staff will be in touch.  No one is turned away for lack of funds!


--> Registration deadline: Oct 5, 2020

This form should be filled out by a parent/guardian, except the section 'About Music & More!,' which should be filled out by the camper.

Application fee: $10. Follow the payment instructions at the end of this form to complete your application. We cannot accept your application until the fee is submitted.

Thanks!
RIOT RI  aka Girls Rock! Rhode Island
Camper Info!
To be completed by parent/guardian
Camper first name *
Camper last name *
Camper preferred name (if different than above)
The name that will be printed on their nametag at camp
Camper address *
Street and Apt/Floor/Unit #
City
State
Zip
Camper phone number
Camper email
Date of birth *
MM
/
DD
/
YYYY
Age at time of camp *
You must be 11-18 years old to attend camp. Campers will participate in developmentally appropriate activities.
Grade camper will enter in fall 2020 *
School camper will attend in fall 2020 *
What kind of school is this? *
Name of primary contact/parent/guardian *
First and last name
Relationship to camper *
Primary contact best phone number (XXX-XXX-XXXX) *
What type of phone is this? *
Primary Contact Alternate Phone Number (XXX-XXX-XXXX)
Optional
What type of phone is this?
Clear selection
Primary contact email
Email is our main mode of communication. Please provide a current, valid email address that you check regularly
What is the best way to contact you? *
What is the best time to contact you?
Secondary contact name
First and last name. In case of emergency only.
Relationship to camper
Relationship to primary contact
Secondary contact best phone number (XXX-XXX-XXXX)
What type of phone is this?
Clear selection
Secondary contact email address
Secondary contact employer
Secondary contact job title
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