Intersession Camp Registration Form: September 30–October 4, 2019 (4th–8th Graders)
Thanks for taking the time to register here for Girls Rock NC's first-ever Intersession Camp for 4th-8th graders at Central Park School for Children Middle School in downtown Durham, from September 30–October 4, 2019. Camp days run from 9am-5pm. Drop off is from 8:30-9am, and we start the day promptly at 9am. You can sign up for aftercare in this application, which extends the day to 6pm.

The camp showcase, which all campers will participate in with their bands, will be at the Pinhook on Friday evening at 6:30pm, the day camp ends.

Intersession Camp tuition = $340. Tuition is due at the time of acceptance. An invoice, which is payable online, will be sent with the acceptance letter. We offer full and partial financial assistance, and you can apply in the Financial Assistance section on page 3. If you have any questions about payment and payment options, please get in touch with our Operations Manager, Dana Livermore at dana@girlsrocknc.org.

The primary reason for application rejection is lack of space for additional campers.

If you have any other questions, please feel free to email us at info@girlsrocknc.org.
Email address *
Contact Information
Legal Camper First Name *
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Preferred Camper First Name (if applicable)
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Camper Last Name *
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Camper Date of Birth *
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Camper's Grade in Fall of 2019: *
Parent/Guardian Full Name *
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Parent/Guardian relation to the camper *
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Parent/Guardian Primary Phone Number *
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Parent/Guardian Secondary Phone Number
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Parent/Guardian Email Address *
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Parent/Guardian Primary Address – STREET *
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CITY *
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STATE *
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ZIP CODE *
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Emergency Contact Full Name *
Please list an emergency contact that is not the primary parent/guardian.
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Emergency Contact Relation to Camper *
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Emergency Contact Phone Number *
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