GRRR 2022 Registration

Girls Rock N Roll Retreat (GRRR) Registration
NOTICE
All 14-16 yr old spots are full. Please get on the waiting list here!
Proof of your child's COVID-19 vaccination is required at camp check in.

All staff and campers at the Girls Rock N Roll Retreat are required to provide proof of COVID-19 vaccination and be able to follow any mask guidelines from local/state/federal officials and the Center for Disease Control (CDC). In case you want to read more about She Rock's committment to ensuring a safe and healthy Retreat, check out our COVID-19 policy & waiver.
To ensure a smooth registration, please read these important documents before continuing.
Financial Aid Notice

If you are eligible for financial aid and intend to apply for a scholarship, do not complete this registration form. Instead complete the Financial Aid application. Please note in 2022, as our grant funding has been very reduced, we are only able to offer a limited number of financial aid scholarships for a limited number of low-income families enrolled in state and federal assistance programs (e.g. EBT/food stamps, free/reduced lunch program, Medicaid, WIC, etc). Thanks for your understanding and patience as we seek to expand financial aid options in 2023.
CAMPER INFORMATION
Camp Session *

Ages 9-13, Session 1: JULY 11-15, 2022 Ages 12-16, Session 2: JULY 18-22, 2022
Camper's name *

First name Last name
(Session One) Camper Age at time of camp: *
(Session Two) Camper Age at time of camp: *
Session One 9-10 yr old Instrument Selection
Session One 11 yr old Instrument Selection
Session One 12-13 yr old Instrument Selection
Session Two 12-13 yr old Instrument Selection
Session Two 14-16 yr old Instrument Selection
Camper's race/ethnicity (please select all that apply; this info is only collected for grant reporting purposes): *

American Indian / Alaska Native Asian American Black / African American Hispanic / Latina or Latino Native Hawaiian / Pacific Islander White / European American Other
OTHER (please share more about your camper's race/ethnicity for grant reporting purposes) *
If different from their first name, camper's preferred name or nickname (for their camp nametag)
Camper's birth date *

Month Day Year
If they have one, camper's phone
Which type of phone is this? *

Mobile Other
If they have one, camper's email
example@example.com
Your camper is expected to arrive between 8:30am-9:00am and depart at 4:30pm during the week. Would your camper be in need of any Before or After-Camp Care (e.g. will they need to arrive between 7:30am-8:30am and be picked up between 4:30pm-5:30pm)? Please note there is an additional $75 fee for this extra care. This fee will be waived for full financial aid campers. *

Yes No
Please describe your camper's musical experience in the past, if any *
How many years has your camper attended GRRR in the past? *
PARENT/GUARDIAN INFORMATION
Parent/guardian name *

First name Last name
Parent/guardian relationship to camper *
Parent/guardian phone *
Which type of phone number is this? *

Mobile Work Other
Parent/guardian email *
Address *

Street address

City State / Province

ZIP / Postal code
If this is your first time participating in a She Rock program, how did you hear about us?
Would you like to be included on a carpool-share list? Thanks for helping out the environment and/or helping a camper who can't afford transportation throughout the Twin Cities! *

Yes No
EMERGENCY CONTACT INFORMATION

Please list another adult—different than the camper's parent/guardian listed above—who should be contacted if there is an emergency and we are unable to reach the camper's parent/guardian.
Emergency contact name *

First name Last name
Emergency contact phone *
Emergency contact email *
example@example.com
MEDICAL/BEHAVIORAL/DIETARY/SOCIAL INFORMATION

Communication between the parents/caregivers and staff is an essential key to our success. We believe in providing a supportive and inclusive environment that meets campers where they are mentally, physically, and developmentally. We welcome campers of all abilities, and to the greatest extent possible, we seek to make adaptations and work with families to ensure that we are able to provide adequate support and create a framework for a safe and positive camp experience. The following questions will assist our staff in caring for your child and creating this experience. Please provide us as much information as possible - anything you think will help us help your camper rock out! This information will be kept confidential and shared only with certain staff members as necessary to provide proper care.
Are there any medical, accessibility, and/or mental health needs that the staff should know about?
Does your camper take routine medications? Include both prescription and over-the-counter, and include name, dosage, and frequency.
If medication needs to be administered during camp, are you giving us permission to do that on your behalf?

Yes No
Does your camper have any medication allergies? Please list them here, including how severe they are.
For example, penicillin
Does your camper have any environmental allergies? Please list them here, including how severe they are.
For example, pollen, bees, etc.
Does your camper have any food allergies (e.g. peanuts) ? Please list them here, including how severe they are.
For example, peanuts, tree nuts, eggs, etc.
Does your camper have any dietary restrictions (e.g. vegan, gluten free, etc.)? Please list them here.
For example, vegan, gluten-free, etc.
How has your camper been adjusting to any changes in the last year?
For example, pandemic isolation, divorce, death of a loved one, new sibling, etc.
Are there any non-medical care recommendations for your child?
For example, behavioral, religious, etc.
Is there any additional information that may be helpful for us to know?
AGREEMENTS
Waiver *

I have read and understood the Camp Waiver.
COVID Policy & Waiver *

I have read and understood the COVID-19 Policy & Waiver.
FAQs *

I have read and understood the Camp FAQs.
Code of Conduct *

I have read and understood the Code of Conduct.
COVID Vaccination *

I understand that my child will be required to show proof of COVID-19 vaccination on the first day of camp check in.
Attendance Expectations *

I understand that my child is expected to attend camp all five days from 9am-4:30pm, and be present at the Friday evening showcase.
PAYMENT
DID YOU KNOW?

Did you know the full actual cost of your camper to attend Girls Rock n Roll Retreat is over $1,000 per week? That includes qualified music coaches, camp counselors, camp administrators, band equipment, instrument rental, art supplies, building rental fees, media and transportation. In order to ensure income is not a barrier for all kids who want to jam, She Rock normally steps up to pay at least 70% of each camper's actual costs, regardless of family income.

However, like many small nonprofit organizations, She Rock has been hard-hit by the COVID-19 pandemic and now more than ever we could really use your help to give young rockers access to our unique summer camp experience. If your family is able, we encourage you to step up for your camper and their friends!

TUITION

PACKAGE

THIS INCLUDES

ADDITIONAL BENEFITS (BESIDES CAMP!)

LET’S ROCK!

$2000

- Full cost for your camper +

- Full cost for another camper who is in need of financial help.

- $1550 will be counted as a tax deductible donation

- PayPal processing fees are waived

- Help your camper find a BESTIE!

I ROCK!

$1000

- Full cost for your camper

- $550 will be counted as a tax deductible donation

- PayPal processing fees are waived

ROCK ME!

$460

- Standard cost for your camper is $450 plus 2% ($10) processing fee

- She Rock will step up to cover your camper's remaining cost

Payment options *

PayPal (includes 2% payment processing fee) Check (PayPal payment processing fees are waived; checks must be mailed within 5 days to hold your camper's spot)
To pay by PayPal: Please select a tuition package and if applicable, select any additional services:
prev next ( X )
LET'S ROCK! $ 2,000.00

I ROCK! $ 1,000.00

ROCK ME! $ 460.00

Before or After Camp Care $ 75.00

I would LOVE to give an additional donation to support She Rock: $ 1.00

$

Total $ 0.00
Pay by Check:
Within five (5) days, please review the payment packages listed above, and then mail your check to:

She Rock She Rock
5115 Excelsior Blvd #316
Minneapolis, MN 55416

As the 2% PayPal processing fee is waived for the "ROCK ME" tuition package, the standard tuition cost is $450 for families paying by check. Additional costs may also include the Before and After Camp Care at $75, if you need it. Finally, any amount you give beyond tuition is considered a tax deductible donation. Thanks for ROCKING us! 

Camper's name (this helps with our payment records) *
Cancellation Policy

Cancellation: In the event you need to cancel, you must notify us by 6/1/22 to receive a refund (less a $25.00 deposit). After 6/1/22, all cancellations are non-refundable and the tuition will be donated to She Rock.
Recordkeeping fields
Service
(Hidden field)
Service Schedule
(Hidden field)
Service Session - Week 1
(Hidden field)
Service Session - Week 2
(Hidden field)
Service Session - Selected
(Hidden field; auto-populates based on which week is selected)
Service Year
(Hidden field)
Financial fields
This year's standard fee
(Hidden)
Before/after care amount
(Hidden; auto-populates as $75 if answered 'Yes' to before/after care above)
Payment amount
(Hidden; populates from the total that shows in the Paypal section above)
Donated amount
(Hidden; auto-calculates as Payment amount - (Standard fee + Before/after care amount))
Race/ethnicity fields
Race/ethnicity - American Indian/Alaska Native
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - Asian
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - Black
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - Lat/Hisp
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - Native Hawaiian/Pacific Islander
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - White
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Race/ethnicity - Other
(Hidden; auto-populates based on race/ethnicity checkboxes above)
Instrument fields
Instrument choice
(Hidden calculation; populates from widget selection above)
Phone fields
Camper - Mobile
(Hidden; auto-populates based on camper phone type and number)
Camper - Other Phone
(Hidden; auto-populates based on camper phone type and number)
Parent/Guardian - Mobile
(Hidden; auto-populates based on parent/guardian phone type and number)
Parent/Guardian - Work
(Hidden; auto-populates based on parent/guardian phone type and number)
Parent/Guardian - Other
(Hidden; auto-populates based on parent/guardian phone type and number)
Agreement fields
Agree - Waiver
(Hidden; auto-populates once corresponding box is checked above)
Agree - COVID Policy and Waiver
(Hidden; auto-populates once corresponding box is checked above)
Agree - FAQs
(Hidden; auto-populates once corresponding box is checked above)
Agree - Code of Conduct
(Hidden; auto-populates once corresponding box is checked above)
Agree - Attendance
(Hidden; auto-populates once corresponding box is checked above)
Agree - Provide Proof of COVID Vaccination
(Hidden; auto-populates once corresponding box is checked above)
Should be Empty:

Girls Rock N Roll Retreat (GRRR) Registration

CAMPER INFORMATION

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT INFORMATION

MEDICAL/BEHAVIORAL/DIETARY/SOCIAL INFORMATION

AGREEMENTS

PAYMENT

Cancellation Policy