GRR! Ladies Rock Camp Fall 2017 Registration!
Hello future Ladies Rock Camper,

We are so psyched to rock out with you! But first... we need a little bit of information! Please take a moment to fill out this registration form. We will be in contact with you shortly!

Thanks so much!

~Girls Rock! Rhode Island

P.S. Ladies Rock Camp is for adults 18+. If you are under 18 and want to participate in our other programs, please contact Johanna at johanna@girlsrockri.org.

First name
Your answer
Last name
Your answer
What name would you like on your nametag at camp?
Your answer
Street Address
Include apartment/floor/unit number
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Email (email is our main mode of communication, please provide an email that you check regularly)
Your answer
Cell phone number
Your answer
Home phone number (if different)
Your answer
Work phone number (if different)
Your answer
Which phone number do you prefer?
Date of birth- this helps us provide information to funders
MM
/
DD
/
YYYY
Race/ethnicity- this helps us provide information to funders
Your answer
Emergency contact first name
Your answer
Emergency contact last name
Your answer
Emergency contact phone number
Your answer
Emergency contact relationship to you
Your answer
Current employer (if applicable)
Your answer
Current job title (if applicable)
Your answer
What gender pronouns do you use? (she/her/hers, they/them/theirs, he/him/hers, etc.)
Your answer
First choice of instrument. Choose one- we try to accommodate everyone's first choice but it is not always possible.
How much experience do you have on your first choice instrument?
Second choice of instrument.
How much experience do you have on your second choice instrument?
On a scale from 1 to 10, how would you feel if your first choice instrument wasn't available
I really, really, really want to play my first choice instrument!
I'm excited to play anything!
Have you attended Ladies Rock Camp before?
Please write a brief paragraph that helps us get to know you. Tell us about why you want to attend Ladies Rock Camp!
Your answer
How did you hear about Ladies Rock Camp?
Your answer
Select your favorite music genres. We know-- this is hard! 3-5 only please!
Required
Who are a few of your favorite bands/artists? 3-5 only please!
Your answer
Do you have friends/family/coworkers joining you at Ladies Rock Camp? If so, who?
Your answer
If you are coming from out-of-town, would you like to room with another participant?
If you live in RI would you be interested in hosting an out-of-town camper?
Do you have any food restrictions?
Required
If you have a gluten intolerance, peanut or tree nut allergy, or other food allergy, please describe severity here:
Your answer
If you have any medical conditions that we should know about, please list them here.
Your answer
Ladies Rock Camp runs Friday 11am-9pm, Saturday 9am-7pm, and Sunday 9am-showcase. Attendance is required for the entire weekend-- your band needs you! Can you commit to attending the entire weekend?
Tuition for LRC is $375. GRR! is able to offer need-based financial assistance to a limited number of campers on a first-come-first-served basis. Would you like to apply for financial assistance?
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