Register for Car Camping Parent/Guardian Name * First Name Last Name Child Name First Name Last Name Child age * 11 12 13 14 15 Parent Phone Number * (###) ### #### Parent Email * Which weekend are you interested in? Weekend 1 (June 21 -23 at Redman Campground) Weekend 2 (October 17 -19 at Goblin Valley) - FULL JOIN WAITLIST Both weekends (Weekend 2 is full, join waitlist) Does your child have any allergies to food, medication, bugs, etc.? * Yes No If yes to the previous question, please further explain. Does your child have any dietary restrictions or take medication? * What are your child's interests and fears? What are your hopes for your child in enrolling them in this program? What is your child's t-shirt size? (men's t-shirt) * Emergency Contact Name * First Name Last Name Emergency Contact Phone Number * (###) ### #### Any additional details we should know? What amount are you comfortable paying? (See suggestion based on family income below) * Under $35,000: Free $35,000 to $50,000 : $50-$100 $50,000 to $75,000 : $100-$125 $75,000 to $100,000 : $125-$150 $100,000+ : $150-250 Thank you for registering your child for camp. We cannot wait to have them join us! To complete registration, please send your 50% deposit to ashley@girlandherbackpack.com through PayPal with your child’s name in the note. Please refer back to the Car Camping overview page to view the packing list for camp. We will provide all gear and food but if there is anything on the packing list that you need us to provide, please email ashley@girlandherbackpack.com — we are happy to provide anything you need!Ashley will reach out to you before camp with the camp itinerary and safety waiver. If you have any questions in the mean time please contact her at Ashley@girlandherbackpack.comThank you again for registering your child, camp is going to be here before we can blink and we can hardly wait!!
