Camp High Rocks

Camp High Rocks Camper Application Form

You are now creating your child's record in our camp database. Please use proper capitalization and be as accurate as possible.

If you would like to register for father-son weekends, please go to: Father-Son Weekends.

Current Photo (optional): (JPEG format only)
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Camper's First Name:

Camper's Middle Name:

Camper's Last Name:

Camper's Preferred Name:

Birthdate:

(mm/dd/yyyy)

Select A Camp Session

* Grade denotes 2022-2023 school year.

3 Weeks $6,475

Sunday, June 4 - Friday, June 23, 2023

Grades: 1st - 10th

4 Weeks $7,875

Monday, June 26 - Saturday, July 22, 2023

Grades: 3rd-10th

July Mini I $4,775

Monday, June 26 - Saturday, July 8, 2023

Grades: 2nd-5th

July Mini II $4,775

Monday, July 10 - Saturday, July 22, 2023

Grades: 2nd-5th

2 Weeks $4,775

Monday, July 24 - Saturday, August 5, 2023

Grades: 1st-7th

1 Week $2,050

Monday, August 7 - Saturday, August 12, 2023

Grades: 1st-4th

June Mini $4,775

Sunday, June 11 - Friday, June 23, 2023

Grades: 2nd-5th

Your Personal Information

Please enter contact information for both parents/guardians, if applicable.

Title:

First Name:

Last Name:

Suffix:

Email Address:

Work/Day Phone:

Cell Phone:

Relationship:

Marital Status:

Occupation:

Second Parent/Guardian

Title:

First Name:

Last Name:

Suffix:

Email Address:

Work/Day Phone:

Cell Phone:

Relationship:

Marital Status:

Occupation:

Formal correspondence to parents should be addressed to:

Home Address:

City:

State:

Zip Code:

Home Phone:

Preferred Email:

(for correspondence)

Billing Email:

Brothers names and ages:

'Sisters' names and ages:

Do any sisters attend a North Carolina Camp?

If so, which camp?

Would you like information on area girls' camps?

Name of School:

Grade completed by June of 2023:

How did you learn of High Rocks?

Please specify how you learned about us. i.e.: family or person's name, camp name, website, etc. :

Camps attended previously:

Years:

My son requests to be in a cabin with:

My son requests to NOT be in a cabin with:

Personal Information

What would you like for us to help your son accomplish during his stay at High Rocks?

Please list any medical or emotional conditions (i.e., enuresis, sleepwalking, ADD or ADHD, anaphylaxis, asthma), which would require special medical attention or added attention from our staff.

Does your son take prescription medication during the school year?
Will he continue them at camp?
Please list and explain:

Please list any food allergies or dietary restrictions. (We are able to make some accommodations for dietary restrictions and allergies. Please contact us for more information about our food and kitchen capabilities.)

Does your son have any learning disabilities? Explain:

Would you like to recommend friends to High Rocks

Name:

Email:

Address:

City: State: Zip:

Phone Number:

Son's Name:

Son's Age:

Name:

Email:

Address:

City: State: Zip:

Phone Number:

Son's Name:

Son's Age:

Please review your application for accuracy. Pay particular attention to capitalization and spelling. This information will go directly into our database. Please read over the terms and conditions. Details about risks, rules, and cancellations are explained in the Acknowledgement of Risk and the Terms and Conditions.

Type the word "Yes" in this box to confirm you have read and agree to the Acknowledgement of Risk, Registration Policies, and the Terms and Conditons page. Click the "Next Steps" button below to view your submission and proceed to our payment page.

Sessions	Dates	Grades	Rates
June – 3 Week	Sun., June 4 – Fri., June 23	1st-10th	$6475
June Mini	Sun., June 11 – Fri., June 23	2nd-5th	$4775
July – 4 Week	Mon., June 26 – Sat., July 22	3rd-10th	$7875
July Mini I	Mon., June 26 – Sat., July 8	2nd-5th	$4775
July Mini II	Mon., July 10 – Sat., July 22	2nd-5th	$4775
August – 2 Week	Mon., July 24 – Sat., Aug. 5	1st-7th	$4775
Junior Camp	Mon., Aug. 7 – Sat., Aug. 12	1st-4th	$2050
Father-Son I	Fri., May 5 – Sun., May 7	K+	$825
Father-Son II	Fri., May 12 – Sun., May 14	K+	$825
Family Camp	Fri., Sept. 1 – Mon., Sept. 4		See Info
	*Grade is 2022-2023 school year

Sessions	Dates	Grades	Rates
June – 3 Week	6/4 – 6/23	1st – 10th	$6475
June Mini	6/11 – 6/23	2nd – 5th	$4775
July – 4 Week	6/26 – 7/22	3rd – 10th	$7875
July Mini I	6/26 – 7/8	2nd – 5th	$4775
July Mini II	7/10 – 7/22	2nd – 5th	$4775
August – 2 Week	7/24 – 8/5	1st – 7th	$4775
Junior Camp	8/7 – 8/12	1st – 4th	$2050
Father-Son I	5/5 – 5/7	K+	$825
Father-Son II	5/12 – 5/14	K+	$825
2022 Family Camp	9/1- 9/4		Varies
	*Grade is 2022-2023 school year