Camp Rockridge Registration Form CC
Camp Rockridge Registration Form CC
Camp Rockridge is June 17-20, 2024
Camper Information
Important: This form is only for Approved Junior Counselors or for Children of Approved Counselors. Both must be approved by Camp Director Pam Murphy.
Select one:
*
Counselor's Child
Junior Counselor
All Counselors and Junior Counselors must be approved by Camp Director Pam Murphy.
Camper's First Name
*
Camper's Last Name
*
Birth Month
*
01
02
03
04
05
06
07
08
09
10
11
12
Select Birth Month
Birth Day
*
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Select Birth Day
Birth Year
*
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
Other
Birth Year
Select Birth Year
Age
*
School Grade Level in Fall 2024
*
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
Jr. Counselor
Grade going into next school term (2024-25)
Gender
*
Male
Female
T-Shirt Size
*
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult XXL
Would you like to request roommates?
*
Yes
No
We will make every effort to honor room-mate requests that are in line with our efforts to group same age /grade and church groups together.
Roommates
Requested Room-mate #1
First and Last Name
Requested Room-mate #2
First and Last Name
If you are human, leave this field blank.