GIRL ZONE Summer Camp 2020 Registration Form
Thank you for your interest in Girl Zone's first ever virtual summer camp starting Monday June 8th, 2020! Girl Zone's summer camp is open to girls and femme identified youth between the ages of 8 and 18 years old.
By completing the form below you will have successfully registered your student for camp. After completing this form, a Girl Zone educator will be reaching out to you soon to follow up and talk more about what to expect from this camp. All parents are required to be present at one of our parent orientations being offered. Parent orientation dates are as follows: Wednesday May 27th at 7pm and Saturday May 30th at 11am. For questions please contact our Girl Zone Program Manager, Vikki Ramirez at 210.557.7287 or at victoria@mswomenscenter.org
Student Full Name
Your answer
Student ID/Lunch Number
Your answer
Student Date of Birth
MM
/
DD
/
YYYY
Student Age
Your answer
Student Ethnicity/Race
If you answered 'Other', please explain
Your answer
Student School
Your answer
Student School District
Your answer
Student Grade 2019-2020 School Year
Your answer
Guardian Full Name
Your answer
Relationship to Student
Your answer
Guardian Phone Number (List all that we can reach you at)
Your answer
Highest Level of Schooling Completed by Guardian
Your answer
Are you a single parent or grandparent?
Home Address
Your answer
Zip Code
Your answer
Number of People Living in Household
Your answer
How many youth under the age of 18 are living in the Household
Your answer
Is there internet at your home?
If you answered 'Yes' to the above question, is your internet access wifi or smart phone?
What is the annual Income of the household?
Emergency Contact (Must be different that guardian listed above)
Your answer
Emergency Contact Phone Number
Your answer
Any additional notes you want Girl Zone to be aware of?
Your answer
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