Camper Registration Form

Registration deadline is may 31, 2022. The total cost to attend camp is $350. A non-refundable deposit of $125 is due at the time of registration in order to secure your spot. The balance ($225) is due in full no later than June 30.

Student Name:


First	Last

Student Nickname:

Student Birthdate: *

Student Age (at time of camp): *

Student Cell (if applicable):

-
Area Code	Phone Number

Student E-mail (if applicable):

Student T-shirt Size: *

Parent/Guardian Name: *


First	Last

Parent/Guardian Address: *

Street AddressCityState / Province / RegionPostal / Zip CodeCountry

Parent/Guardian E-mail: *

Parent/Guardian Cell Phone: *

-
Area Code	Phone Number

Approved Contact #1 Name:


First	Last

Approved Contact #1 Cell Phone:

-
Area Code	Phone Number

Approved Contact #2 Name:


First	Last

Approved Contact #2 Cell Phone:

-
Area Code	Phone Number

Approved Contact #3 Name:


First	Last

Approved Contact #3 Cell Phone:

-
Area Code	Phone Number

How will the student get to and from camp each day?: *

Parent

Friend

Bus

Walk

I will pay by: *

If paying by check, please make checks payable to:

Girls Rock Camp Houston

3707 Mulberry St., #1

Houston, TX 77006

Please include your camper's name and your phone number on the check.

Payment Options:

I acknowledge that I have read, understand and agree that the $125 deposit is non-refundable and that the balance ($225) is due in full no later than June 30.

I acknowledge that I have read, understand and agree to the Girls Rock Camp Houston Covid-19 measures outlined on our Covid-19 webpage to make camp as safe as possible.

Word Verification:

Girls Rock Camp Houston

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Camper Registration Form

Registration deadline is may 31, 2022. The total cost to attend camp is $350. A non-refundable deposit of $125 is due at the time of registration in order to secure your spot. The balance ($225) is due in full no later than June 30.

Camp Instrument

Camp Transportation:

Payment Method

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