Summer Camp Registration
Wilson's Rising Stars Youth Academy
What camp are you registering your child for?
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Main Street Multi-Purpose located at (101 W 48th Street, Jacksonville, FL 32208)
Child's Name
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First Name
Last Name
Suffix
Child's Age
Birthday child 1
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Month
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Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What grade will your child be in 2026/2027? (We will introduce some academics for your child's next school year once per week)
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Age
Shirt Size
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Please Select
xs youth
s youth
m youth
L youth
XL youth
S Adult
M Adult
L Adult
XL Adult
XXL Adult
Mother/Father/Guardian Name
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First Name
Last Name
Mother/Father/Guardian Name
First Name
Last Name
E-mail
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Phone Number
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Area Code
Phone Number
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. Choose the option that best fits your family’s needs and pricing preference.
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4-Week Summer Bundle — ONLY $250
Part-Time Camp — $65 per week
Daily Drop-In Rates — Starting at $25/day
2-Day Pass (Includes Field Trip + Pool Day!) — $75
Regular weekly rate: $75 (Not Including Field Trips)
Sibling Discount — $65 per child
Other
If a different Fee was discussed, please write the amount here.
Extended hours fees (varies by location, extended hours fee will be added to your weekly fee)(There will be a $10 off per service for siblings).
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$20 per week (Before, 6:30am @48th & Main, 7:00am-8:00am 103rd)
$20 per week (After 4:00pm-6:00pm)
$40 per week Before & After
$10 per week (Sibling Discount) (Before, 6:30am @48th & Main, 7:00am-8:00am University)
Extended hours are not needed
REGISTRATION FEE ( Registration fee pays for camp supplies, tshirt,) (Fee may be paid with link below, Registration Fee is Non-refundable)
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$30 Registration
How do you wish to pay activity fee?
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$115 Every 3 Weeks
$80 due at start of camp, then $35 each week for the next 7 weeks
$40 weekly
Other
ACTIVITY FEE (Field Trips are optional) (Activity Fee is Non-refundable, as it will be used to pre-pay for trips/buses, etc.) (The activity Fee Covers all field trips, special activities, special guests) Field trips are additional fee & we will send out permission slip form for trips.
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I understand
Any additional comments such as promotions we ran/etc
Did anyone refer you to camp, if so... who? Or where did you hear about our camp?
Please type your full name in box, then sign below box.
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Signature
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