25/26 Enrollment Form
Open Enrollment is 2/25-5/31! (Enrollment deposit increases 6/1)
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Email *
Campus Location: 12000 Olive Drive  

Submission of this form is Acknowledgment of Parent File Documentation for the "participant" named in submission.

Electronic Signatures below acknowledge and accept:

  • Financial and Policy Agreement
  • KRC Activities & Sports
  • Photo Liability Waiver
  • Credit Card Authorization 
  • Fee Schedule 2025
VOLUNTEER BACKGROUND CHECK:
All parent volunteers are required to submit a background check annually. Once payment is received, we will forward a link to complete the next steps:
Student #1 *
First and Last Name - Grade (25/26)
Date of Birth: *
Student #2 *
First and Last Name - Grade (25/26)
Date of Birth:
Student #3 *
First and Last Name - Grade (25/26)
Date of Birth: *
Student #4 *
First and Last Name - Grade (25/26)
Date of Birth: *
Photo Liability: Photographs or videos may be used for KRC Marketing *
Required
Parent Full Name *
Parent Contact Number *
Address *
Emergency Contacts
Does your child(ren) have any food allergies? Please list name and allergen(s).
Credit Card Authorization *Tuition payments will be charged automatically on the 1st of each month.
I acknowledge that Kern Resource Center will submit credit card payment with below listed card for Monthly Tuition Payment on the 1st of each month. Unsuccessful charges or late payments not received by the 5th will be subject to a 10% service fee.

Full Name on Card: 
 *
Credit Card Number: *
CC Issuer (ie. Visa, Mastercard)
 *
 CCV (Security Code back of card) *
Billing Zip Code *
Open Enrollment for New Families 
February 25th - June 1st
Early Enrollment Deposit: $600 

After June 1st, enrollment deposit increases to $750 per student to secure a spot. 


*Tuition and Enrollment Fees are non-refundable 
 *
A copy of your responses will be emailed to the address you provided.
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