Rokstra Camp Registration
Parent Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Child Name
*
First Name
Last Name
Child Age / Grade Level
*
Experience Level
*
My Products
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Week 1 - Classic Rock Camp
July 17-21
$
499.00
Week 2 - Pop Rock Camp
July 24-28
$
499.00
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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