We Rock! Application

50%

Please fill out this application to attend the GRA Rock Retreat, Presidents' Day Weekend, February 15th-17th, 2020. Camp will be held at Griffin School, 5001 Evans Ave, Austin, TX 78751. Showcase on Monday, February 17th (location TBA). Please remember that applications are not complete until payment is made. If you need to discuss a payment plan, or have any other questions regarding your enrollment, please email Jamie Bahr at Jamie@girlsrockaustin.org Thank you!
Section Break
Legal Name*
First Last
Preferred/Personal Name*
Preferred/Personal Name
If you have another name you'd like to go by, please enter here. If N/A please write N/A.
Gender Pronouns
- She, her, hers
- He, him, his
- They, them, theirs
Please check all that apply.
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Emergency Contact 1 Phone*
Please list any dietary allergies, restrictions, or needs:*

Is this your first time attending Girls Rock Austin?*
How did you hear about Girls Rock Austin?*
Are you applying with a friend, for the friend rate of $500/2 campers?*
- Yes
- No
If you are applying for the friend rate, please list the name of the person applying/attending with you.*
Please write your first instrument choice (guitar, bass, drums, keys and vocals).*
Please write your second instrument choice (guitar, bass, drums, keys and vocals).*
Please write your third instrument choice (guitar, bass, drums, keys and vocals).*
Please describe what, if any, experience you have playing music. Experience isn't necessary, we love teaching beginners!!*
Camper Tuition*
Please note in order to receive the "Early Bird" rate, your application must be completed and submitted by December 31st, 2019. To receive the "Bring a Friend Rate," you and your friend must both indicate that you are coming together, by writing this on the application or contacting us at jamie@girlsrockaustin.org.
Total
$0.00
Payment Type*
- Credit Card
- Mail-in Check
Select how you'd prefer to pay, either credit card or checks made and mailed to:
Girls Rock Austin
PO Box 300897 Austin, TX 78703
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Section Break