Name of Camper
*
First Name
Last Name
Birthdate of Camper
*
MM
DD
YYYY
Age of Camper at Time of Camp
*
Camper's Pronouns
*
She/Her/Hers
He/Him/His
They/Them/Theirs
Ze/Zir/Zirs
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Name of Primary Contact for Camper
*
First Name
Last Name
Email Address for Primary Contact
*
Phone Number for Primary Contact
*
(###)
###
####
Preferred Camp Session
*
We will do our very best to place each camper in their preferred session. Scheduling flexibility is very much appreciated!
Can the Camper attend the other session if the preferred session is filled?
*
Has the Camper attended Girls Rock Camp before?
*
We ask experience to help best inform program-level placement during camp.
Instrument Choice A
*
Campers will be assigned one of their two instrument choices.
How much experience does the Camper have on the chosen instrument?
*
How long has the Camper played this instrument?
*
Instrument Choice B
*
Campers will be assigned one of their two instrument choices.
How much experience does the Camper have on this instrument?
*
How long has the Camper played this instrument?
*
The Camper is:
*
What is the Camper most looking forward to about Girls Rock Camp?
*
Please tell us, in the Camper's own words, why they would like to attend camp, what they hope to get out of it, and/or what music means to them.
What does the Camper want their bandmates and fellow campers to know about them?
*
Do they have a special talent or skill that they think others would appreciate? Is there something the Camper loves to do and wants to share? Are they excited, nervous, outspoken, shy? Let us know that unique thing about you!
Please list any medical conditions or food allergies the Camper may have in the space below:
*
Favorite pizza topping(s):
*
Check all that apply.
Does the Camper have any behavioral, physical or developmental conditions that we should be aware of?
*
These types of conditions will not exclude a Camper from camp. Our staff and volunteers will do our best to make accommodations that we are able to.
Please let us know of any special requests:
Want to be in the same band as your friends? Don't want to be in the same band as your sibling? Let us know and we'll do our very best to accommodate your request. Special requests are not guaranteed.
What are the Camper's top five (5) favorite bands, artists or songs?
Does the Camper have a Rock Star Stage Name?
Would your Camper like to be listed in our Camp Directory, to be shared with interested Campers after camp has concluded?
*
How did you hear about Girls Rock MKE?
*
(Check all that apply)
If "other" how did you hear about Girls Rock Milwaukee?
The following information is optional and confidential, and will only be used for grant reporting purposes.
*
What school does the Camper attend?
School Zipcode
Household Income (Annual)
Which race/ethnicity best describes the Camper?
(Please choose only one.)
If you chose "other" above, please describe the Camper's race/ethnicity.
Get ready to rock!
Each camper's registration will be processed, and individuals will be notified of their instrument assignment and final details as soon as possible prior to the camp session.
You have one step left to finalize your registration and confirm your spot at camp. Please pay your $50 nonrefundable deposit OR pay your full tuition ! If you are unable to pay the full amount of tuition, there is limited financial assistance available. Apply for financial assistance here .
Registration forms will be reviewed, and we will be in touch to confirm your submission.
Please note: your $50 deposit must be submitted in order for your registration to be considered complete.
