2018 Little Girls Rock Application!

Camper Information
Camper's Name *
Camper's Name
Camper's Date of Birth *
Camper's Date of Birth
(at time of camp)
Street Address *
Street Address
Primary Contact / Parent / Guardian Full Name *
Primary Contact / Parent / Guardian Full Name
Home / Preferred Phone *
Home / Preferred Phone
Cell / Work Phone *
Cell / Work Phone
Extended Information
*Our organization does not discriminate on the basis of identity or expression. In order to track effectiveness of our recruiting efforts and to ensure we consider the needs of all of our campers please consider the following optional questions.
Racial / Ethnic Identity *

*Your application will not be considered complete without the $10 application fee. Please click below and follow the prompts. 

**If you are applying for a scholarship to camp, you are not required to pay the $10 application fee.