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 2024-2025 school year.

3 Weeks $7,075

Sunday, June 8 - Friday, June 27, 2025

Grades: 1st - 10th

June Mini $2,225

Sunday, June 15 - Friday, June 27, 2025

Grades: 3rd - 5th

July Mini I $5,225

Monday, June 30 - Saturday, July 12, 2025

Grades: 2nd-5th

4 Weeks $8,550

Monday, June 30 - Saturday, July 26, 2025

Grades: 3rd-10th

July Mini II $5,225

Monday, July 14 - Saturday, July 26, 2025

Grades: 2nd-5th

2 Weeks $5,225

Monday, July 28 - Saturday, August 9, 2025

Grades: 1st-7th

1 Week $2,225

Monday, August 11 - Saturday, August 16, 2025

Grades: K-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 2025:

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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