Camps 4 Girls

(360) 878-2043

Olympia, WA

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Camps
About
Volunteer
- Board Member Application
Donate
Blog
Events
- Summer Solstice

Camp Registration

Empowerment Camps

1-DAY CAMPS
April 30 and December 17
9:30 AM - 4:00 PM

WEEK-LONG CAMP
July 18 - 22 and August 29 - September 2
9:30 AM - 4:00 PM

Conscious Minds Conscious Bodies™
CMCB Camps

1-DAY CAMPS
February 12 and November 5
9:30 AM - 4:00 PM

WEEK-LONG CAMP
August 15 - 19
9:30 AM - 4:00 PM

CAMP LOCATION
The Coach House
211 21st Ave SW
Olympia, WA 98501

Driving Directions

TO REGISTER:

Complete the Camp Registration form on the right, including the Pre-Camp Questionnaire.
Make your $100 deposit to reserve your space. Weeklong deposits are non-refundable. 1-Day deposits are refundable prior to 72 hours notice if you have to cancel.

APPLYING FOR A SCHOLARSHIP?
Please complete our Scholarship Questionnaire to be considered for a scholarship for one of our Camps, then return to this page and complete your registration.

Scholarship Questionnaire

QUESTIONS? Call or Email Kristen
(360) 878-2043
hello@empowerment4girls.com

2022 Camp Registration

Please indicate which camp program you're registering for, then select the correct date. If you want to register for more than one camp, you must complete a separate Camp Registration for each camp.

* Indicates required field

Which program is this registration for: Conscious Minds Conscious Bodies (CMCB) or Empowerment? *

CMCB Empowerment

Choose the correct camp date. *

February 12 - CMCB April 30 - Empowerment July 18-22 - Empowerment weeklong August 15-19 - CMCB weeklong Aug 29 - Sept 2 - Empowerment weeklong November 5 - CMCB December 17 - Empowerment

Parent or Guardian *

First

Last

Email Address *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Person Attending *

First

Last

Age *

Please give us the age of the person attending.

Birthdate *

Please enter the birth date of the person attending.

Pre-Camp Questionnaire

Please take a moment and answer the following questions. All information provided will be stored securely. Personal information will only be shared with Empowerment 4 Girls Camp staff and pre-screened camp volunteers, as needed.
Click the (?) for detailed instructions for each question.

1. Dietary Restrictions *

Please list all dietary restrictions if any? (Gluten/dairy free, etc.) If none, please enter NONE

2. Food Preference *

Vegan Vegetarian Meat Eater

What is your food preference?

3. Does your child have any medical conditions or other health restrictions? Are they on any medications? *

Please let us know about any medications, medical or health conditions we need to be aware of. If none, please enter None.

4. What is your Annual Household Income? *

$0-$16,910 $16,911-$25,750 $25,751-$34,590 $34,591-$43,430 $43,431-$51,500 $51,501-$60,340 $60,341-$69,180 $69,181-$77,250 $77,251-$86,860 $86,861-$103,770 $103,771-$117,030 $117,031-$130,290 $131,291-or more

Annual Household Income includes all income made by members of your household.

5. How many people are supported by your Annual Household Income? *

2 3 4 5 6 7 8

Include all people who are supported by your Annual Household Income.

6. Racial Makeup of Household - Choose all that apply *

American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or other Pacific Islander White

Providing this optional information supports our fundraising and program evaluation efforts.

7. Does your child exhibit any behavioral, emotional or developmental challenges? *

Anxiety Depression Suicidal Thoughts or Expression Aggression Toward Others Self-Harm Learning Disabilities None of the Above

Please let us know if your child has experienced any of the following:

7a. Please explain above choices: *

Please explain your selection of the above items. For example, if you choose Learning Disabilities, please indicate what these are.

8. How do you think this camp will benefit your child and your household? *

Also let us know if you think there will be benefits to others in your household.

9. What are some of the expectations you have in your child attending this camp? Choose any that apply. *

Positive Body Image Become More Empowered Increase Confidence Puberty/Menstruation Education Gender Identity/Sexual Orientation Building Healthy Relationships Consent/Boundaries Resiliency Stress Reduction Spiritual Growth Connecting with Others Social Media Awareness Needed a Place for My Child Other - Please Explain Below:

9a. Please explain Other expectations *

In none, please enter none

Is this child in the foster care system? *

Please indicate whether or not this child is in the foster care system.

You will be asked for your payment on the next page after you click Register below.
You must pay a $100 nonrefundable deposit to complete your Registration.
Scholarship applicants please use $0 Scholarship Application Pending option on the next page after you click on Register.

Register

Empowerment 4 Girls

A 501(c)(3) Nonprofit Corporation
EIN: 81-4391734
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Board of Directors

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Contacts

Kristen Rubis, Program Director
360-878-2043
hello@empowerment4girls.com

Jeannine Anderson, Operations Director
360-463-6405
admin@empowerment4girls.com

Mailing Address

9134 Steamboat Island Rd NW
Olympia, WA 98502

2022 Business Sponsors

We are so grateful for the businesses who so generously support us.

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