2026 Vision and Vibes Camp

Vision and Vibes Summer Camp 2026

Location: Long Branch Park - 4110 Franklin Street, Jacksonville 32206
This camp is designed for campers between the ages of 13-18.
Youth's Legal Name

First NameLast Name
Nickname
Birthdate

MonthDayYear
Date
Age
Gender
Race/Ethnicity
Preferred Pronouns
Last 4 of SSN
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School Name
Current Grade Level
Student ID (Numbers Only. Do not include the 'S')
Needs-Based Scholarship

Scholarship positions are limited and will require proof of need. Cost of the program without the scholarship is $500 and can be split into payments.
Apply for Needs-Based Scholarship?

Needs-Based Scholarship

Scholarship positions are limited and will require proof of need. Cost of the program without the scholarship is $500 and can be split into payments.
Please explain your need for the scholarship (household size, students in college, income restriction, etc.)

Registration Fee

NON-REFUNDABLE

June 2nd - June 18th, Tues-Thurs, 9AM-2PM

$10.00

Total

Credit Card

Apple Pay

Cash App Pay

ACH Bank Transfer

Review and Sign

By signing below, I attest to the truthfulness of all information listed on this application and agree to all the above terms and conditions.
Name

First NameLast Name
Date

MonthDayYear
Date
Relationship to Youth
Emergency Contact Information
This number should be for the on-call person who will be responsible for taking any incident reports regarding youth or to pick up youth if absolutely necessary.
Should be Empty:

Vision and Vibes Summer Camp 2026