Summer Camp Registration
Wilson's Rising Stars Youth Academy
What camp are you registering your child for?
*
Main Street Multi-Purpose located at (101 W 48th Street, Jacksonville, FL 32208)
Child's Name
*
First Name
Last Name
Suffix
What grade will your child be in 2025/2026? (We will introduce some academics for your child's next school year once per week)
*
Mother/Father/Guardian Name (Additional parents/ emergency contacts will be added on brightwheel)
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
E-mail
*
Does your child have any special needs, medical conditions, medications or allergies? if yes, please explain. (If more than one child write the name and the special need next to the name.)
Camp FEES. I understand that I will pay the following fees due every Friday, which is for camp for the following week. The first week's payment is due on or before the 1st day of camp. (No refunds for unused days or weeks of camp)
*
$125 per week 1 child
$115 per week per child (sibling discount)
$100 per week, per child for (3 or more children)
Special pre-determined discount
If a different Fee was discussed, please write the amount here.
REGISTRATION FEE + Supplies. ( Registration fee pays for camp supplies, tshirt, summer camp year book) (Fee may be paid with link below, Registration Fee is Non-refundable)
*
$25 Last 2 weeks of camp (Shirts available if we have extra)
Extended hours fees (varies by location).
*
$10 per week (Before, 6:00am @48th & Main, 7:00am-8:00am Cassatt)
$10 per week (After 5:00pm-6:00pm)
$20 per week Before & After
Extended hours are not needed
ACTIVITY FEE (Activity Fee is Non-refundable, as it will be used to pre-pay for trips/buses, etc.) (The activity Fee Covers all field trips except end of Summer Field Trip) Field trips are additional fee & we will send out permission slip form for trips.
*
I understand
Did anyone refer you to camp, if so... who? Or where did you hear about our camp?
I understand that immediately following this form I will be directed to brightwheel to finish the registration process & enter other important information such as other parent or emergency contacts. Registration is not complete until you fill that out, if for some reason you exit the site please message us for a link. Also download brightwheel app afterwards; which is where all communication will come from.
*
Yes
Please type your full name in box, then sign below box.
*
Summer Camp Registration, please select one that applies to you.
*
prev
next
( X )
Registration
$
25.00
Registration, 1 child $25
Quantity
1
Enter coupon
Apply
Subtotal
$
0.00
Tax
$
0.00
Total
$
0.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Signature
*
Save
Submit
Should be Empty: