Girls Rock Cincinnati Camper Application 2019
Campers do not need any musical experience! We welcome all skill levels.
Girls Rock Cincinnati is a camp for girls and gender-variant youth ages 12-18. We teach electric guitar,
electric bass, drums, keyboard, and vocals. Campers form bands, work together to write original songs,
and play a public concert at the end of the week for their families and community members.
Camp is $50 - $150 sliding scale, and scholarships are available. Email girlsrockcincinnati@gmail.com with any questions.

Camp Dates:

August 4 - 10
Sunday 12:00pm - 5:00pm
Monday-Friday 9:00am - 5:00pm
Saturday 2:00pm - 7:30pm
Saturday evening concert at 7:30pm

Camp Location:

MYCincinnati Firehouse
3120 Warsaw Ave
Cincinnati, OH 45205

Please carefully read and complete all of this form. Thank you for your interest!
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Untitled Title
Name of camper *
Date of birth *
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Pronouns *
Name you prefer to be called
Name of Parent/Guardian *
Parent/Guardian phone number(s) *
Parent/Guardian Email *
Home Address *
If you are interested in carpooling, from which school/part of town will you be traveling?
Do you need transportation assistance? *
Will you need to be dropped off at camp early? (8:30 is the earliest time) *
Languages spoken *
The instruments we offer are Guitar, Bass, Drums, Vocals and Keys.
Please choose your first, second and third choices below. If you already have experience playing an
instrument or have attended previous years of camp, consider using this year's rock camp as an
opportunity to try something new. NO EXPERIENCE NECCESARY!
First choice instrument *
Please check the statement that best describes you and your FIRST choice instrument: *
Second choice instrument *
Please check the statement that best describes you and your SECOND choice instrument: *
Third choice instrument *
Please check the statement that best describes you and your THIRD choice instrument: *
Would you like to bring any of the following instruments with you to camp?
Are you right or left handed?
Clear selection
If left handed, would you prefer to play your instrument with your dominant hand (i.e. play a left handed guitar, etc.)?
Clear selection
Tell us about yourself! What are you interested in? What are your hobbies? *
What are you looking forward to about rock camp? *
What kind of music do you like? Who are your favorite bands or musicians? *
Emergency contact #1 Name, Relationship, & Phone Number *
Emergency contact #2 Name, Relationship, & Phone Number *
Does the camper have any medical or behavioral conditions, emotional concerns, allergies, or special needs which the staff should know about? *
If so, is the camper taking any medications that camp staff may need to know about? Will the camper need to take medication during camp and will they need assistance taking it? *
Does the camper have any mobility concerns we should know about? Our venue is a historic, three-floor building with no elevator. We are working hard to ensure a fully accessible venue for camp next year. *
How did you hear about us? *
In order to maintain a safe campus, everyone who attends programs at Girls Rock Cincinnati must read and agree to the Code of Conduct. Thank you for your cooperation. https://www.girlsrockcinci.com/conduct *
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