Camper's Full Name
*
First Name
Last Name
Camper's Pronouns
Date of Birth
*
MM
DD
YYYY
Parent/Guardian's Name
*
First Name
Last Name
Parent/Guardian Email
*
Parent/Guardian Phone
*
(###)
###
####
Address
*
Camper must reside within the Oak Park community.
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
County
*
Sacramento County
El Dorado County
Nevada County
Placer County
Sutter County
Yolo County
Other
Emergency Contact Name
*
Adult other than parent/guardian listed above
First Name
Last Name
Emergency Contact Phone
*
(###)
###
####
School camper is attending in Fall 2024
*
Grade level camper is entering in Fall 2024
*
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Age at time of camp
*
How many GRS camps previously attended?
*
0
1
2
3 or more
Experience with 1st instrument choice
*
No experience is necessary, but let us know what experience you have, if any. How long have you been playing? Have you had lessons? Have you played this instrument at camp before, or are you trying something new (we encourage that!)
Experience with 2nd instrument choice
*
T-Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult XS
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
If your response is yes, does your camper have any food allergies or restrictions that we should be aware of?
Does the camper have any behavioral, medical, or emotional issues that the staff should know about? If so, please explain. Are they are taking any medications?
*
We ask so that we can be sure we are able to best serve our campers and have adequate staff on hand if special attention is needed.
How did you hear about the COME Play program?
*
Word of Mouth
Internet Search
Social Media
Media/Presentation
Brochure
St. Hope/Sac High
Mutual Assistance Network
Which of the following best represents your camper's racial or ethnic heritage? Choose all that apply.
*
Native American or Alaskan Native
Black, Afro-Caribbean, or African American
Latinx or Hispanic American
Asian or Pacific Islander
South Asian or Indian American
Middle Eastern or Arab American
Non-Hispanic White or Euro-American
Other
With which of the following does your camper identify?
*
Please check all that apply. Thank you for providing this information, which helps us with grant reporting!
LGBTQ2S+
Female
Male
Transgender
Immigrant
Refugee
Person with a Disability
Justice Impacted Person
Other