CAMPER INFORMATION

NOTE: If you are registering more than one camper,
please fill out a separate registration form for each camper.

Name

Date of Birth

Gender

Male
Female

What grade did this camper recently complete?

T-Shirt Size

This is my first year attending Camp Rock

Registration

Regular Price ($59.00)
[Through July 22]
Regular Price (plus processing fee) ($63.00)
You can choose this option if you'd like to cover the cost of the RegFox processing fees.

Discount Code

Our hope is that no camper will be turned away from Camp Rock because of finances. Would you be willing to provide financial support towards another camper's registration fee? If you can, thank you!

Below, please fill in the amount you would like to donate.

If you need financial assistance, please email us at [email protected]

Donation Amount

Total

$59.00

TERMS & CONDITIONS

Terms & Conditions

While we hope everyone who registers will be able to attend all of Camp Rock, we understand that illness and exposure can prevent people from participating. Cancellation prior to the first night of camp will allow for a full refund. Cancellation during camp will allow for a prorated refund based on the number of nights attended.

I have read and agree to the terms above.

PARENT / GUARDIAN INFORMATION

Name

Address

Phone Number

BILLING INFORMATION

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Phone Number

Event Registration Software by RegFox