Register Kids

KBC Student Registration

* Student First Name

* Student Last Name

* Grade

Please enter ONLY a number for Grade

* Gender

Male Female

* Birthdate

Shirt Size

* Student Address

Apartment No.

* City

* State

* Zip Code

* Beach Club Location

select one

select one
Academy of the Arts at Bransom Elementary (Burleson ISD, Texas)
Adobe Acres Elementary (Albuquerque Public Schools, New Mexico)
Altruria Elementary (Bartlett City Schools, Tennessee)
Arbor Creek Elementary (H-E-B ISD, Texas)
Austin Elementary - Baytown (Goose Creek Consolidated ISD, Texas)
Austin Elementary - Mesquite (Mesquite ISD, Texas)
Bailey Elementary (Hillsborough County Public Schools, Florida)
Barksdale Elementary (Rockdale County Public Schools, Georgia)
Bayless Elementary (Lubbock ISD, Texas)
Bell Manor Elementary (H-E-B ISD, Texas)
Big Sandy Elementary (Big Sandy ISD, Texas)
Bon Lin Elementary (Bartlett City Schools, Tennessee)
Bowie Elementary (Richardson ISD, Texas)
Bukhair Elementary (Richardson ISD, Texas)
Canton Intermediate (Canton ISD, Texas)
Caprock Elementary (Keller ISD, Texas)
Carroll Elementary (Corsicana ISD, Texas)
Carroll Elementary-Southlake (Carroll ISD, Texas)
Cavanaugh Elementary (Fort Smith Public Schools, Arkansas)
Charger Academy (Tipton County Schools, Tennessee)
Charleston Elementary (Charleston Public Schools, Arkansas)
Curlew Creek Elementary (Pinellas County Public Schools, Florida)
David Crockett Elementary (Weatherford ISD, Texas)
Eisenhower Elementary (Pinellas County Public Schools, Florida)
EK Key Elementary (Calcasieu Parish Public Schools, Louisiana)
Ellendale Elementary (Bartlett City Schools, Tennessee)
Emma B Ward Elementary (Anderson County Public Schools, Kentucky)
Glen Hope Elementary (Grapevine-Colleyville ISD, Texas)
Grace Hardeman Elementary (Birdville ISD, Texas)
Grapevine Elementary (Grapevine-Colleyville ISD, Texas)
Hackberry Elementary (Little Elm ISD, Texas)
Hanby Elementary (Mesquite ISD, Texas)
Hawkins Elementary (Hawkins ISD, Texas)
Highlands Grove Elementary (Polk County, Florida)
Hillsboro Intermediate (Hillsboro ISD, Texas)
Hodges Elementary (Mesquite ISD, Texas)
Holiday Heights Elementary (Birdville ISD, Texas)
Hood-Case Elementary (Alvin ISD, Texas)
Johnson Elementary (Carroll ISD, Texas)
Kemp Intermediate West (Kemp ISD, Texas)
Kimball Elementary (Mesquite ISD, Texas)
Kit Carson Elementary (Madison County Schools, Kentucky)
Lake George Elementary (Orange County Public Schools, Florida)
Lake St. George Elementary (Pinellas County Public Schools, Florida)
Lakewood Elementary (H-E-B ISD, Texas)
Lancaster Elementary (Orange County Public Schools, Florida)
Lummus Intermediate (Ennis ISD, Texas)
Mary Moore Elementary (Arlington ISD, Texas)
McCall Elementary (Aledo ISD, Texas)
Mohawk Elementary (Richardson ISD, Texas)
Molino Park Elementary (Escambia County School District, Florida)
Moss Elementary (Mesquite ISD, Texas)
Mulkey Elementary (Geneva City Schools, Alabama)
Norman Binkley Elementary (Metropolitan Nashville Public Schools, Tennessee)
Northwest Elementary (Brownwood ISD, Texas)
Norwood Elementary (Burleson ISD, Texas)
Oak Elementary (Bartlett City Schools, Tennessee)
Oak Point Elementary (Little Elm ISD, Texas)
Oakwood Terrace Elementary (H-E-B ISD, Texas)
Ocean Springs Upper Elementary (Ocean Springs School District, Mississippi)
Old Union Elementary (Carroll ISD, Texas)
Panter Elementary (Paulding County Public Schools, Georgia)
Passmore Elementary (Alvin ISD, Texas)
Peaks Mill Elementary (Franklin County Public Schools, Kentucky)
Pearson Elementary (Garland ISD, Texas)
Pinar Elementary (Orange County Public Schools, Florida)
Pine Meadow Elementary (Escambia County School District, Florida)
Pine Street Elementary (Rockdale County Public Schools, Georgia)
Poynter Elementary (Crowley ISD, Texas)
Range Elementary (Mesquite ISD, Texas)
Remington Point Elementary (Eagle-Mountain Saginaw ISD, Texas)
Rhodes Intermediate (Forney ISD, Texas)
Ripley Elementary (Lauderdale County, Tennessee)
Robinson Elementary (Hillsborough County Public Schools, Florida)
Rock Springs Elementary (Orange County Public Schools, Florida)
Rockenbaugh Elementary (Carroll ISD, Texas)
Rugel Elementary (Mesquite ISD, Texas)
Rutherford Elementary (Mesquite ISD, Texas)
Saffell Street Elementary (Anderson County Public Schools, Kentucky)
Sand Hill Attendance Center (Greene County Public Schools, Mississippi)
Seminole Elementary (Pinellas County Public Schools, Florida)
Shady Oaks Elementary (H-E-B ISD, Texas)
Shands Elementary (Mesquite ISD, Texas)
Shenandoah Elementary (East Baton Rouge Parish, Louisiana)
South Euless Elementary (H-E-B ISD, Texas)
Southaven Intermediate (DeSoto County Schools, Mississippi)
Spring Garden Elementary (H-E-B ISD, Texas)
Springhead Elementary (Hillsborough County Public Schools, Florida)
St Martin Upper Elementary (Jackson County, Mississippi)
Stamping Ground Elementary (Scott County Schools, Kentucky)
Stephens Elementary (Garland ISD, Texas)
Sunnyvale Intermediate (Sunnyvale ISD, Texas)
Tarkington Elementary (Tarkington ISD, Texas)
Taylor Elementary (Burleson ISD, Texas)
Tildenville Elementary (Orange County Public Schools, Florida)
Tioga Elementary (Tioga ISD, Texas)
Utopia School (Utopia ISD, Texas)
Viridian Elementary (H-E-B ISD, Texas)
Walnut Grove Elementary (Carroll ISD, Texas)
Wheatley Elementary (Orange County Public Schools, Florida)
Whitesburg Elementary (Carroll County Schools, Georgia)
Wilson Elementary (Hillsborough County Public Schools, Florida)
My school isn't listed

School Name & City

Parent/Guardian 1

* First Name

* Last Name

* Mobile Phone

* May we have permission to text you with questions or additional updates

Yes No

* Email

Please enter only one valid email address

Permission to pick up student after club

Yes No

Would you be willing to volunteer in your student's Beach Club?

Yes No

Church Information

* Do you attend church?

Yes No

Name of church

If you don't attend church, what is your religious preference?

Student Pickup (Please complete if plan to be in-person)

My student will be picked up

Yes No

My student has permission to walk home

Yes No

My student has permission to ride their bike home

Yes No

My student attends the after-school child care after Beach Club

Yes No

Student Medical/Allergies

Student Food Allergies?

Student Medical Needs?

Parent/Guardian 2

First Name

Last Name

Mobile Phone

Email

Please enter only one valid email address

Permission to pick up student after club

Yes No

Additional Emergency Contact Required for In-Person Beach Club, (in the event parents/guardians cannot be reached during club)

First Name

Last name

Mobile Phone

Permission to pick up student after club

Yes No

In addition to parent/guardian and emergency contact, my student has permission to be picked up by

From time to time KiDs Beach Club® or the partnering church may take photographs/video to capture the fun kids have at Beach Club.

Information provided on this form will be provided to KiDs Beach Club® and the local partnering church. We promise to only send a reasonable amount of communication each month. You may unsubscribe at any time, beginning with our first contact.

T-shirts are provided at the discretion of the partnering church.

With my electronic signature below, I certify I am the parent, guardian or other adult with legal parental authority to complete this registration form, and give my permission as a parent or legal guardian for this student to attend Beach Club. I have reviewed, understand and agree to the KBC Privacy Policy and the Authorization and Release of Liability.

* Type Full Name

* Type Email

Student Registration Form