Girls Rock Austin
Empowering Girls & Women Through Music Education & Performance
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2013 Ladies Rock Camp Registration
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Email
*
Phone
*
Have you attended Ladies Rock Camp before?
Yes
No
What is your first choice instrument to play at camp?
*
drums
bass
guitar
keyboard
voice
What is your second choice instrument to play at camp?
*
drums
bass
guitar
keyboard
voice
What is your third choice instrument to play at camp?
*
drums
bass
guitar
keyboard
voice
Would you be OK with being assigned to your second or third choice instrument at camp?
Sometimes we have to move some people from their first choice for instrument balance, but if you have your heart set on your first choice, please let us know!
If you have previous musical experience, please indicate it here
Do you have an instrument at home that you would like to use at camp? What instrument?
(its OK if you don't, as we can provide instruments)
Do you have any special dietary needs or restrictions? If so, please note them here.
We provide lunch and snacks during camp.
How did you hear about Ladies Rock Camp?
Tell us anything else you would like us to know about you.
(optional, keep it simple)
I understand that by submitting this form I am applying to attend Ladies Rock Camp in February 2013, and that I am making a commitment to attend and to pay the necessary tuition before the session begins.
*
Please verify this statement with your initials.
Registration
*
Receive two registrations for $500 when you bring a friend!
LRC Single Registration
LRC Bring a Friend Registration
Friend Name
Please make sure your friend signs up within 48 hours so that we can properly assign the discount
First
Last
Total
When you click "submit" you'll be taken to PayPal to complete your transaction. if you don't have a PayPal account, look for, "Don't have a PayPal account? Use your credit card or bank account (where available)." and click "Continue".
$0.00
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