Camper's Full Name

First Name

Last Name

Camper's Preferred Name/Nickname

If different than their full name. This is what we will call them at camp!

Camper's Pronouns

Is your camper able to commit to all of the camp dates listed above, as well as the Saturday showcase?

Space in this camp is limited, and as each camper will be placed in a band and collaborating on an original song with 3-4 other youth, daily attendance at camp is necessary in order to achieve success at the Saturday performance!

If you selected NO above, please explain:

Date of Birth

YYYY

Parent/Guardian's Name

First Name

Last Name

Parent/Guardian Email

Parent/Guardian Phone

(###)

###

####

Address

Camper must reside within the Del Paso Heights community.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

County

Emergency Contact Name

Adult other than parent/guardian listed above

First Name

Last Name

Emergency Contact Phone

(###)

###

####

School camper is attending in Fall 2025

Grade level camper is entering in Fall 2025

Age at time of camp

This camp is for ages 8-11 only

How many GRS camps previously attended?

FIRST Instrument Choice

Strings, sticks, or keys! Choose the instrument you'd most like to play - we encourage trying something new! We'll do our best to assign your 1st or 2nd choice, but as we need a certain ratio of instruments in order to form bands, there are no guarantees. Please note: everyone can sing if they'd like to, but we are no longer accepting "vocals" as a primary instrument selection option.

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!)

SECOND Instrument Choice

MUST BE DIFFERENT FROM 1ST CHOICE. Strings, sticks, or keys! Reminder: everyone can sing if they'd like to, but we are no longer accepting "vocals" as a primary instrument selection option.

Experience with 2nd instrument choice

Does your camper sing?

Check all that apply!

Yes! They sing lead!

Yes! They can sing backup!

No, they would rather not sing.

If you checked YES above, what is their singing experience?

Joining camp with a friend? (ONE friend only)

We encourage our campers to meet and collaborate with new people at camp, but will try to accommodate placing your camper in a band with ONE friend only. We do not allow for groups of 3+ friends to join camp as a "band." If they have one friend signing up for camp too, what is their friend's name?

T-Shirt Size

Gender neutral sizing

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 G.I.R.L.S. Rock Sacramento?

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

LIABILITY RELEASE

I understand that attending camp will involve activities such as, but not limited to, a loud environment, self-defense workshops, active group games and movement activities, and using electrical equipment. The parent/guardian of the named child above acknowledges that they have enrolled a child in camp offered by Girls Rock Sacramento and are willing to waive, release, and hold Girls Rock Sacramento harmless from all claims, demands, causes of action, liabilities, losses, damages and costs that may arise from any and all injuries and damages sustained while at camp.

MEDIA CONSENT

Photographs of campers attending our programs are used for promotional purposes. However, Girls Rock Sacramento will not publish photographs of participants without permission. Please consider the following waiver: I give Girls Rock Sacramento permission to photograph my child and use my child’s likeness to promote Girls Rock Sacramento in print and online. I understand such images will only be used to promote these education programs and I hereby give my permission to use such material without further claim on my part. SELECTING NO MEANS THAT YOUR CAMPER WILL NOT PARTICIPATE IN BAND OR CONCERT PHOTOS OR BE LISTED IN THE CONCERT PROGRAM.

Thank you for submitting your application.

G.I.R.L.S. ROCK SACRAMENTO

DEL PASO HEIGHTS CAMP