Camper Application

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)

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 2023-2024 school year.

3 Weeks $6,850

Sunday, June 9 - Friday, June 28, 2024

Grades: 1st - 10th

4 Weeks $8,275

Monday, July 1 - Saturday, July 27, 2024

Grades: 3rd-10th

July Mini I $5,025

Monday, July 1 - Saturday, July 13, 2024

Grades: 2nd-5th

July Mini II $5,025

Monday, July 15 - Saturday, July 27, 2024

Grades: 2nd-5th

2 Weeks $5,025

Monday, July 29 - Saturday, August 10, 2024

Grades: 1st-7th

1 Week $2,150

Monday, August 12 - Saturday, August 17, 2024

Grades: 1st-4th

June Mini $5,025

Sunday, June 16 - Friday, June 28, 2024

Grades: 2nd-4th

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 2024:

How did you learn of High Rocks?

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.

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