Girls Rock Vermont- Camper Application 2017

Although the required questions are indicated by a red asterisk, we ask that you answer every applicable question. Your application will not be received until you select "Submit" on the last page and see the confirmation message that will pop up.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Camp Instrument

    Drums
    Guitar
    Bass
    Keyboards
    Ukulele
    Please enter one response per row
    This is a required question

    Parent/Guardian and Emergency Contact Information

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    CAMPER MEDICAL AND BEHAVIORAL INFORMATION

    Please list all known conditions so that we may accommodate your camper’s needs. All information will be kept confidential and shared only with the camp nurse and staff as necessary to provide proper care.
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Financial Aid

    This is a required question
    This is a required question
    This is a required question

    Demographics Survey

    Please fill out the following demographics survey. Creating a group of campers that reflects the diversity of Vermont communities is a camp priority. In addition, some of our potential funders require the racial/ethnic and economic composition of our camp population to be documented in aggregate anonymously. Providing the following information will help us meet our goals and help us to receive funding for future camp sessions. Thank you so much for your time & information!
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question