Register for Rise Child Name First Name Last Name Child age * 12 13 14 15 16 17 What weekend(s) are you interested in? * July 17-19 - Lake Mary, Martha, Catherine Aug. 1-3 - Lower Red Pine August 7-9 - Uintas Clyde Lake Loop How much are you comfortable paying for camp? (See ranges suggested by family income below) * Under $35,000: Scholarship (Free) $35,000 to $50,000 : $75 - 150 $50,000 to $75,000 : $150-$225 $75,000 to $100,000 : $225-$300 $100,000 to $150,000 : $300-$375 $150,000+ : $375 - $500 Parent/Guardian Name * First Name Last Name Parent Phone Number * (###) ### #### Parent Email * Emergency Contact Name * First Name Last Name Emergency Contact Phone Number * (###) ### #### Does your child have any allergies to food, medication, bugs, etc.? * Yes No If yes to the previous question, please further explain. What are your child's interests and fears? What is your child's t-shirt size? (men's t-shirt) * Does your child have any dietary restrictions or take medication? * What are your hopes for your child in enrolling them in this program? Any additional details we should know? * Thank you for registering your child for camp. We cannot wait to have them join us!To complete registration, please send your full payment to ashley@girlandherbackpack.com through PayPal with your child’s name in the note.Please refer back to the Rise 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!!
