Girls Rock Application - Girls Rock Austin

Thank you for your interest in Girls Rock Austin's. We are looking forward to receiving your GRA After School application. Please read it carefully – there is a lot of information and we cannot consider incomplete applications. Applications are NOT COMPLETE and will NOT BE CONSIDERED until all materials (Express Yourself Pieces, Letters, and Application Fees) are received.
Tuition for each camp session is $400. We do offer a sliding scale. Please fill out the Financial Aid applications if a reduced tuition amount is needed.

After School Payment Deadlines:
- Session 1 payment due by September 1st, 2020
- Session 2 payment due by September 28th, 2020
Acceptance is on a first-come, first-served basis—space permitting.

Some students MAY be admitted after these dates if space is still available.

In order to continue to ensure the safety and health of all our campers, staff and volunteers, all programs will be held virtually through November 1st. GRA After School will include live instrument instructions, collaborative workshops and a livestream song showcase at the end of each session.

You may send application via email or mail.

Applications require a $10 non-refundable processing fee.

Tuition can be paid as soon as the camper is accepted. Be sure to note the payment deadlines for each session. If you need to make payment arrangements, please contact Jamie Bahr at jamie@girlsrockaustin.org.

If you are applying for financial aid, please be sure to include that form when you submit this application. You will be notified of your financial aid status when you are notified of acceptance. No camper will receive financial aid without submitting the financial aid form.

HOW TO COMPLETE THIS APPLICATION: Ideally, the camper will fill out Sections 3-6. Please have the parent/guardian review these sections, and fill out Sections 1, 2, and 7-9. Form must be filled out in one session and will not be complete until you click 'submit' at the end.

NOTE: The application form will attempt to save your status, so you don't lose your place, if you leave and return to complete it later. However we recommend you complete it all at once, if possible.

Please note that with every application we require an 'express yourself' piece. We want to know more about our campers and why you want to attend rock camp. This will help us when making decisions regarding their band placement and which workshops they'll attend.
Are you signing up your child for the GRA After School 2021 Virtual Session??
- Yes, please sign my kiddo up!
- No thanks, maybe next time.
Starts Thursday, March 25th, 2021 from 4-6 PM.
Does the camper own or have access to a personal device to use for camp, such as a computer, laptop, tablet or cell phone?*
- Yes
- No

Camper Name*
First Last
Gender Pronouns*
- She/Her
- They/Them
- He/Him
Date of Birth*
Age*
At time of camp
Home Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is your mailing address different?*
- No
- Yes
Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If different than home address
Name of Parent/Guardian*
First Last
Primary Phone*
Secondary Phone
Email*

How did you hear about Girls Rock Camp Austin?
What school do you currently attend?
Have you attended a rock camp before?*
- Yes
- No
When, where, and what instrument(s) did you play at a previous Girls Rock Camp?
What ethnicity/ethnicities do you consider yourself?

Select all that apply to you. (This question is for reporting purposes only and will not impact your acceptance to camp.)
- White/Caucasian
- Latinx
- Asian
- African American
- Native American
- Native Hawaiian or Pacific Islander
- Other
Other ethnicity

Please be sure to let camper answer sections 4 and 5, as it is hard for us to accommodate requests to switch instruments once camp has started.

Please mark “1” by your first choice and “2” by your second choice
Guitar
Keyboards
Bass
Drums
Vocals
What is your experience, if any, with your instrument of choice?
Name 3 songs you can play on your instrument of choice (if possible)
Name a few of your favorite bands
We love beginners! If you are a beginner, please tell us why you chose your instrument of choice.
Are you left handed or right handed?*
- Right
- Left
If you are a returning camper, can you please tell us something you would like to do differently this year?

Older and returning campers will have the choice to get in-depth and work the entire week on one topic of their choosing. Please mark “1” by your first choice and “2” by your second choice, and so on. All new (non-returning) campers age 8-10 will be placed in the Electric Youth workshop. Workshops subject to change/based on availability.
Music Criticism
Please enter a value between 1 and 7.
Recording
Please enter a value between 1 and 7.
DJ skills
Please enter a value between 1 and 7.
Music Video
Please enter a value between 1 and 7.
Podcasting
Please enter a value between 1 and 7.
Tech
Please enter a value between 1 and 7.
Electric Youth
Please enter a value between 1 and 7.
(Games and activities for new campers, age 10 and 11)
If you are an older or a returning camper, please tell us why you chose the above workshop(s).

We want to know more about you, why you want to attend rock camp and what music means to you. There are a million ways to express yourself: write a poem, a story, or a letter; make a collage; draw a picture; take pictures; make a video; record a song; et cetera. Please know that these pieces may not be returned to you, so send us something we can keep.

Also include a letter with your piece, telling us why you want to come to camp.

Please make sure your piece is no bigger than 8.5x11 and must fit in a #10 envelope.
How do you want to submit your personal expression sample?*
- I will upload my art/poem/picture right now.
- I will send it in by mail. Please make sure your piece fits in a #10 envelope.
How do you want to submit your letter?
- I will upload my letter right now.
- I will send it in by mail
Please send your example of personal expression and/or letter to:

Girls Rock Camp Austin
Application Department
PO Box 300987
Austin, TX 78703
Personal Expression file*
Please upload your artwork, poem, etc... here.
Letter*

(Sections 7-9 to be completed by parent/guardian.)
Contact Name 1*
First Last
Relationship to Camper
Primary Phone*
Secondary Phone
Contact Name 2
First Last
Relationship to Camper
Primary Phone
Secondary Phone
The following information is very important, as it helps us provide the best care and supervision we can. All medical/behavioral information will be kept confidential, and shared only with camp nurses, counselors, and staff as necessary to provide proper care. Please include any medications the camper is taking.
Does the camper have any medical conditions or allergies?*
- Yes
- No
Please list the medical conditions / allergies*
So that we may best serve your child, please let us know of any specific needs she may have in any emotional, behavioral, social, or learning areas*
If none, please type, "No specific needs."
Is she on any medication(s) to treat any of the above-mentioned condition(s)?*
- Yes
- No
Please list medications*

T-shirt sizes*

Rock Camp does not provide lunch for campers. Campers need to bring lunch each day. We cannot provide refrigeration or re-heating for lunches. However, if the child is eligible for free lunch at school, and would like free lunch at camp, please check the appropriate box on the financial aid application and we will make arrangements for lunch to be provided for them.

Girls Rock Austin Media Release Form, I, Parent/Legal Guardian of (child’s name insert below) hereby authorize Girls Rock Austin and those acting pursuant to its authority, or with its permission, to interview and/or to have photographs, audio, or audiovisual recordings made of the above-named child (“Media Images”). I further grant permission to Girls Rock Austin, its agents and assigns, to use the above-named child’s name, voice, photo, video, interview, performance and likeness for promotion of Girls Rock Austin camps, programs, and events for all forms, media and manners, including, but not limited to footage, videos, audio recording, promotional pieces, documentaries, DVDs, documentaries, news releases, photographs, website, internet mediums, marketing, advertising, trade, promotion, and exhibition for an indefinite period of time. I give unrestricted permission for images, videos, and recordings of the child to be used in print, video, digital, and internet media in whole or in part. I agree that these images and/or voice recordings may be used for a variety of purposes and that these images may be used without further notifying me. Girls Rock Austin shall own all rights, title, and interest in and to the Media Images, to be used an disposed of at the discretion of Girls Rock Austin. I acknowledge that neither the child nor I will be compensated for the use of these Media Images. In consideration for attendance at camp, campers hereby grant Girls Rock Austin a nonexclusive, perpetual, irrevocable, royalty-free, fully paid-up, worldwide license to copy, sell and distribute in any manner any songs created by campers while attending Girls Rock Austin (the “Songs”) and to incorporate the Songs, in whole or in part, into derivative works for sale and distribution without limitation. Campers retain ownership and all other rights in the Songs. I acknowledge that I have legal authority to approve this form on behalf of the minor named below.
Untitled
- First Choice
- Second Choice
- Third Choice
In consideration of the acceptance of my child, into the Girls Rock Camp Austin summer session this year, I hereby acknowledge and ASSUME THE RISKS BOTH KNOWN AND UNKNOWN related to my child’s participation in this activity and, to the fullest extent permitted by the law, WAIVE, RELEASE, AND DISCHARGE GIRLS ROCK CAMP AUSTIN AND GIRLS ROCK AUSTIN FROM ANY AND ALL CLAIMS FOR DAMAGES FOR DEATH, PERSONAL INJURY, PERMANENT DISABILITY OR PROPERTY DAMAGE, that I may have or my child may have, or that may subsequently accrue to or my child, as a result of my above-named child’s participation in this year’s Girls Rock Camp Austin summer session, whether or not resulting from negligence or misconduct of Girls Rock Camp, Girls Rock Austin, and their agents, employees, volunteers, sponsors, affiliates, and Board Members. I further understand and agree that this GENERAL RELEASE AND WAIVER OF LIABILTY applies to the fullest extent permitted by the law to WAIVE, RELEASE, AND DISCHARGE GIRLS ROCK CAMP AUSTIN AND GIRLS ROCK AUSTIN FROM ANY AND ALL CLAIMS FOR DAMAGES FOR DEATH, PERSONAL INJURY, PERMANENT DISABILTY, OR PROPERTY DAMAGE that may arise from any transportation provided to or for my child during this year’s summer session of Girls Rock Camp Austin by any agent, employee, volunteer, affiliate or Board Member of Girls Rock Camp Austin and Girls Rock Austin. I acknowledge and ASSUME THE RISKS BOTH KNOWN AND UNKNOWN related to the provision of such transportation.
Parent/Guardian Initials*
Media and Liability Agreements

In addition to this form, you'll need to send in, via mail, the following:
- Non-Refundable $10 application fee (unless paying online via PayPal or credit card, see below)
  (Check or money order payable to Girls Rock Austin. Please be sure to include in the memo “[Name of Camper], Girls Rock Camp application fee.”)
- The “Express Yourself” piece (unless uploaded already). Make sure your name is on it!
- The “Express Yourself” letter (unless uploaded already), explaining why you want to attend camp.
- Financial Aid Application (optional, separate form)
By postal mail to:
Girls Rock Camp Austin
Application Department
PO Box 300897
Austin, TX 78703

All materials must be mailed to our P.O. Box, or sent via email. No drop-offs are allowed.

Any photos, recorded (audio or video) and written materials created for and/or during camp are property of Girls Rock Austin and may be used for promotional purposes in the future. Girls Rock Austin does not discriminate on the basis of race, religion, national and/or ethnic origin, marital status, sexual orientation, mental or physical ability, or gender identity in the administration of any of its educational programs, admissions policies, scholarships, or other camp-related policies and programs; nor in any of its volunteer or employment-related policies or activities.
How would you like to pay?*
- PayPal, please visit http://www.paypal.me/GirlsRockAustin
- GRA Website (secured through Stripe), please visit: https://www.girlsrockaustin.org/donate/
- Mail: GRA, PO Box 300897, Austin TX 78703

GRA 2021 Virtual Programs Application