2019 Summer Camp Application Session I
This application will take 10-15 minutes to complete in most cases.

Your application will not be received until you select "Submit" at the bottom and see the confirmation message.

Although the required questions are indicated by a red asterisk, we ask that you answer every applicable question.

CAMP SESSION
Please confirm that you are applying for Session I (July 15-July 20, 2019) *
If not, please return to the application page and apply for Session II
Please confirm that the applicant is available for all days/hours of the program (M-F 9-5), including the showcase on Saturday, July 20, 2019. *
CAMPER BASIC INFORMATION
Camper First Name *
Your answer
Camper Last Name *
Your answer
Age At Camp *
Your answer
Birthdate *
(mm/dd/yyyy)
Your answer
Camper School and Grade (for 2019/2020 school year) *
Your answer
Has your camper attended Rain City Rock Camp for Girls Summer Camp before? *
If yes, what year(s)?
Your answer
What is the camper's gender pronoun?
ie: she/her, they/them, etc.
Your answer
CAMPER MEDICAL AND BEHAVIORAL INFORMATION
Please list all known conditions so that we may accommodate your camper's needs. It is very important that all conditions are reported to us with detail. This will not affect their acceptance into camp and will help us to provide necessary staffing and support. All information will be kept confidential and shared only with the camp staff as necessary to provide proper care for your camper. Please let us know everything that we need to know to best serve your camper.
Does the camper have any medical conditions or allergies? *
Required
If yes, please list *all* medical conditions and/or allergies in detail.
Your answer
Is the camper on any medication to treat these conditions? If so, please list.
Please note: Medication can not be administered by camp staff or volunteers.
Your answer
Does the camper have any behavioral or emotional issues? *
Again, it is very important that all conditions are reported to us with detail. This will not affect their acceptance into camp and will help us to provide necessary staffing and support.
Required
If yes, please list in detail.
Your answer
Is the camper on any medication to treat these conditions? If so, please list.
Please note: Medication can not be administered by camp staff or volunteers.
Your answer
Most of our camp activities are broken out generally into 4 age groups: 8-9, 10-11, 12-13, and 14-17. Which age group do you feel is most appropriate for your camper?
Is there anything else you feel we need to know about your camper in order to best accommodate their needs?
Please be specific. ie: do they need extra breaks? More adult support?
Your answer
PARENT/GUARDIAN INFORMATION
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Street Address - Home *
Your answer
City - Home *
Your answer
State - Home *
Your answer
Zip Code - Home *
Your answer
Street Address - Mailing
If different from home
Your answer
City - Mailing
Your answer
State - Mailing
Your answer
Zip Code - Mailing
Your answer
Parent/Guardian Email *
Your answer
Home Phone *
Your answer
Work Phone
Your answer
Cell Phone
Your answer
What is the best way to contact you with routine information or questions? *
Our primary method of communication is email.
EMERGENCY CONTACTS
First Emergency Contact
Please indicate who should be considered as First Emergency Contact.
First Emergency Contact's Name
If not the Parent/Guardian listed above.
Your answer
Relation to Camper
Your answer
First Emergency Contact's Home Phone
Your answer
First Emergency Contact's Work Phone
Your answer
First Emergency Contact's Cell Phone
Your answer
First Emergency Contact's Email Address
Your answer
Second Emergency Contact's Name *
Your answer
Relation to Camper *
Your answer
Second Emergency Contact's Home Phone
Your answer
Second Emergency Contact's Cell Phone *
Your answer
Second Emergency Contact's Work Phone
Your answer
Second Emergency Contact's Email Address *
Your answer
Are there any other email addresses that should be receiving email communication about camp?
Your answer
DEMOGRAPHICS SURVEY
Frequently, we are required to report on the demographics of our camp to funders, the Girls Rock Camp Alliance, and other agencies. All statistics are reported in aggregate and anonymously.

This information is very important and will not affect your camper's admittance into camp.

Providing the following information will help us meet our goals. Thank you so much for your time and information!

1. Does your camper qualify for free/reduced lunch at school?
2. Estimated household annual income
Your answer
3. How many people live in your household?
Please list the number of adults and the number of children.
Your answer
4. Please check any and all that apply to your camper, or write their preferred identity.
5. How did you hear about us? (Both for the first time and more recently?)
Be specific as possible, including names! (List friends, websites, news organizations, radio shows, etc.) We would like to know which areas of outreach are working for us, so the more detail you provide, the better!
Your answer
TUITION GUIDELINES
Tuition is due immediately upon the receipt of enrollment confirmation. In most cases, these emails are sent no longer than 14 days after application submission.

Please indicate what you can pledge for tuition below. We will email you with confirmation of enrollment and pledge amount. Again, this is sent within two weeks. Payment is due at that time. Tuition: Sliding scale** $425 – $25. We appreciate your support in paying what you are able.

Payment plans are also available. If you would like to use this option, please contact: programsupport@raincityrockcamp.org.

**A sliding scale is a tool that can provide equitable access to skill-building and life-long learning opportunities, regardless of financial resources. This method of payment requires active participation and personal reflection on what makes sense for your family’s financial situation, and how you would like to support knowledge-sharing in the Rain City Rock Camp community. The sliding scale is one way of acknowledging differences in wealth, income, costs, and privilege and actively address the economic disparities in our communities and society. Rain City Rock Camp is moving towards this model as a way to say ‘no’ to the ways things are and ‘yes’ to the ways we believe things can be, while providing an excellent rock camp experience for all.

Please indicate the amount of tuition you will be paying.
Note: Anything over $425 is a tax deductible donation.
Your answer
Please provide more information about your answer above.
This will help us to better understand your situation. All information is confidential.
Your answer
CAMPER INFO- THE FUN STUFF!
Who are some of your favorite bands or musicians?
Your answer
Please indicate your first, second, third, fourth, and fifth choices in camp instrument. *
We will do our best to give you your first choice, but to form bands we need a certain ratio of instruments. Not everyone will get their first choice of instrument, but every instrument is awesome!
First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
Guitar
Bass
Drums
Vocals
Keys
Do you have any experience playing a musical instrument?
Please note: Instrument experience is not required.
Your answer
Are you right or left handed?
EXPRESS YOURSELF PIECE GUIDELINES
The Express Yourself Piece (EYP) component of the Summer Camp application is a way for us to get to know you better!

We are asking that all campers create something that exemplifies who you are and what the theme of the year means to you. This year's theme is "Rock It Like We Talk It!" This theme was created by our Programs Team and we are so excited to hear about all the ways that YOU Rock It Like You Talk It!

Here are some thoughts from them about the theme to get you started:

"Rocking it is being accountable to yourself. It's being true to your word and following through with your plans."
"Rocking it is putting ideas into action!"
"We're taking the things that we learn at camp and applying them to our personal lives."

The EYP can be in any format you choose, such as a painting, song, video, collage, etc. The more creative, the better! We are so excited to see what you come up with and may even feature your EYP on the RCRC Instagram page!

Please send your Express Yourself Piece within two weeks of application. Please email programsupport@raincityrockcamp.org with your submission.

APPLICATION CHECKLIST
I understand that I must send in my Express Yourself Piece to programsupport@raincityrockcamp.org within two weeks of applying for my enrollment to be confirmed. *
I understand that I will be notified within two weeks of application with enrollment status. Tuition will be due at that time. *
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