Register "*" indicates required fields Step 1 of 7 - Camper Information 14% FacebookThis field is for validation purposes and should be left unchanged.CAMPER INFORMATIONChild's Name* First Middle Last Birthdate* MM slash DD slash YYYY Age (as of June 8, 2026)*3456789101112Gender* Male Female Child Resides with:* Father Mother Both Other If Other, please explain*T-Shirt Size*Youth XSYouth SYouth MYouth LYouth XLLadies' SLadies' MMen's SMen's MAdd additional camper?*YesNoCAMPER INFORMATION #2Child's Name* First Middle Last Birthdate* MM slash DD slash YYYY Age (as of June 8, 2026)*3456789101112Gender* Male Female Child Resides with:* Father Mother Both Other If Other, please explain*T-Shirt Size*Youth XSYouth SYouth MYouth LYouth XLLadies' SLadies' MMen's SMen's MAdd additional camper?*YesNoCAMPER INFORMATION #3Child's Name* First Middle Last Birthdate* MM slash DD slash YYYY Age (as of June 8, 2026)*3456789101112Gender* Male Female Child Resides with:* Father Mother Both Other If Other, please explain*T-Shirt Size*Youth XSYouth SYouth MYouth LYouth XLLadies' SLadies' MMen's SMen's MAdd additional camper?*YesNoCAMPER INFORMATION #4Child's Name* First Middle Last Birthdate* MM slash DD slash YYYY Age (as of June 8, 2026)*3456789101112Gender* Male Female Child Resides with:* Father Mother Both Other If Other, please explain*T-Shirt Size*Youth XSYouth SYouth MYouth LYouth XLLadies' SLadies' MMen's SMen's M PARENT / GUARDIAN INFORMATIONFather's Name* First Middle Last Birthdate* MM slash DD slash YYYY Father's Email Father's Cell PhoneMother's Name* First Middle Last Birthdate* MM slash DD slash YYYY Mother's Email Mother's Cell PhoneAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÃ…land Islands Country Best Contact Email* Best Contact Number* EMERGENCY CONTACT #1Emergency contacts must be at least eighteen (18) years old and should not be a parent or legal guardian. Please provide at least 2.Contact #1* First Last Phone*Relationship to Child*Email* Authorized to pick-up your child(ren) from camp?* Yes No EMERGENCY CONTACT #2Contact #2* First Last Phone*Relationship to Child*Email* Authorized to pick-up campers from camp?* Yes No Other Contacts?*Other Contacts?YesNoEMERGENCY CONTACT #3Contact #3* First Last Phone*Relationship to Child*Email* Authorized to pick-up campers from camp?* Yes No Other Contacts?*Other Contacts?YesNoEMERGENCY CONTACT #4Contact #4* First Last Phone*Relationship to Child*Email* Authorized to pick-up campers from camp?* Yes No MEDICAL INFORMATIONPlease answer thoroughly.Do your child(ren) have any allergies or food restrictions?* Yes No If yes, please check all that appply:* Food Allergy Medication Allergy Environmental Allergy Other Please list specific allergies, the severity, and any symptoms/signs we should look for.*Do your child(ren) have any medical conditions?* Yes No If so, please check all that apply:* Asthma Diabetes Epilepsy/Seizures Cognitive or Learning Disabilities Other If other, please explain.*Please provide further information, triggers, and symptoms/signs we should look for.*What are steps our staff should follow or additional information that will be a help in the event of an emergency?*Is your child(ren) taking any medications or supplements?* Yes No If yes, what kind and why?*What medications are we authorized to provide?*Are there any other medical conditions that we should be aware of?*PHYSICIAN AND INSURANCE INFORMATIONPhysician's Name* First Last Physician's Phone Number*Insurance Company*Policy Number* TERMS AND CONDITIONSPaymentAll payments are non-refundable. Payment refunds will only be considered if the student has a medical emergency and an authorized doctor’s note is provided. Monthly payments must be paid by the designated day each month. Full payments must be received by the first day a child is registered for to be eligible for the 5% full-payment discount. Registration fees ($15) are due with the registration form. Deposit fees ($15 per month) are also due with the registration form and are applicable toward the initial tuition subtotal. Campers will not be allowed to attend until payment has been made and are not allowed to stay late or switch days to make up for late arrival or missed days. Late payments result in an automatic billing fee of fifteen dollar ($15) per month. Cost, fees, discounts, and their terms and conditions are listed above and are subject to change at anytime. All discounts are applicable only with five (5) full weeks minimum of summer registration unless otherwise noted. All discounts are applicable only once and cannot be applied to any registration changes. Stacked discounts are subtracted biggest to smallest from each subsequent subtotal. Late pick-up fees are billed automatically and are one dollar ($1) per minute after the child’s specified pick-up time. Any registrations must be made at least one (1) full business day prior and payment must be made before any camper will be allowed to attend Shining Stars Day Camp.SecurityDesignated pick-up/drop-off persons should be over eighteen (18) years old and may be asked to provide a photo ID to the staff. If a camper needs to be picked up by someone other than a parent, please email shiningstars@fallsbaptist.org no later than the morning of the change. In emergencies, we may accept a phone call during the day. If a camper needs to be picked up at an unusual time or needs to leave and return within the same day, the office must be notified no later than the morning of. The safety of all children is our first priority. Doors to the building are locked during camp hours, and campers will not be released to anyone other than a parent, legal guardian, or designated pick-up person. No camper may be under the care of Shining Stars Day Camp for more than ten (10) hours per day. When campers require assistance using the bathroom, two teachers will always be present in the restroom. No teacher will be alone with a child at any time in a bathroom stall. All campers must be potty-trained. Two teachers will be present in a classroom; if a second teacher is not available, the teacher will remain visible from the hallway and the door will be propped open.MedicalFor the safety of every camper at Shining Stars Day Camp, any camper with a communicable disease or a fever over one hundred (100) degrees will be asked to stay back from day camp during the entire contagious period and until he is symptom and fever free without medication for at least twenty-four (24) hours. If campers develop an illness at camp, they will be kept away from other students. The parent(s) or legal guardian will be contacted and asked to pick up their child(ren) as soon as possible. For non-communicable diseases, parents are welcome to provide medicine with their children. These will be kept in the office and administered by a teacher according to the given instructions or written instructions from the parent(s) or legal guardian. Basic first aid may be administered to any camper at Shining Stars Day Camp. Incidents will be documented for security purposes, and the parent will be notified if the child displays severe discomfort or injury relating to that incident. If immediate medical treatment is necessary, appropriate action will be taken including, but not limited to, emergency transportation. Campers with severe allergies will be asked to provide an EpiPen, which will be kept nearby at all times. Campers with asthma will be asked to provide an inhaler, which will also be kept nearby at all times. Parent(s) or legal guardian will be responsible for any expenses resulting from medical treatment or emergency transportation.Field TripsThe Shining Stars Day Camp takes field trips on most Thursdays under the supervision of the teachers at Shining Stars Day Camp. Because field trips often begin promptly at 8AM, it is important that campers arrive on time to ensure a smooth schedule and a prompt return before 4PM. A tentative list of field trip locations will be provided the week of the first field trip. Because many of these field trips will take place outside, sunscreen and/or bug spray is recommended. Other field trips planned by the class teacher may also occur throughout the week. Details for these field trips will be communicated to the parent(s) or legal guardian of those campers no later than the evening before. TransportationTransportation is provided for campers for each field trip. Wisconsin state law requires children to be in a car seat until they reach age four (4) and 40 pounds, and in a booster seat until they reach age eight (8), more than eighty (80) pounds in weight, or more than 4 ft. 9 in. tall. Parent(s) or legal guardian must provide a labeled booster or car seat for their child(ren).Photo ReleaseEach summer, photos will be taken during the day camp hours, on field trips, and on activities. These photographs may be used in promotional videos and/or paraphernalia, posted on the Shining Stars website, or used in any publication of Falls Baptist Church.Pick-Up and Drop-OffCampers may be dropped off in the morning as early as 7:45. Any camper dropped off earlier will be charged the normal daily fee for early/late stay. A grace period of fifteen (15) minutes after the four p.m. pick-up is given each day. Late pick-ups are calculated by any time after the four p.m. grace period or six p.m. if registered for late stay. Consent* I agree to the TERMS AND CONDITIONS. SUMMER SCHEDULEDownload the following file and upload the completed schedule below.Summer Schedule* Drop files here or Select files Max. file size: 2 GB, Max. files: 4. We are excited to work with you and your children this summer! Please let us know if you have any questions or comments. Feel free to reach out to us at any time at shiningstars@fallsbaptist.org. Δ
