Online Preschool Registration

Please mark the session for which you are registering: *

3yr old - Tuesday & Thursday, 8:45am-11:15am, $130.00 3yr old - Tuesday & Thursday, 8:45am-12:15pm, $165.00 4yr old - Monday, Wednesday, & Friday, 8:45am-11:15am, $155.00 4yr old - Monday, Wednesday, & Friday, 8:45am-12:15pm, $200.00 Begindergarten- 4 1/2 - 5yr old - Monday through Friday, 8:45am-12:15pm, $320.00

How did you find out about BSLC Preschool? *

Tell us about your Child. We want to get to know him/her (experiences in a group, personality, likes, dislikes, fears, etc.) *

Primary Mailing Address: *

Line 1

Line 2

City

State

Zip Code

Country

Secondary Mailing Address: *

Line 1

Line 2

City

State

Zip Code

Country

PARENT/GUARDIAN 1

P/G1 Name: *

First

Last

P/G1 Relationship: *

P/G1 Cell Number: *

P/G1 Work Number: *

P/G1 Email: *

P/G1 Home Number: *

P/G1 Employer: *

Parent/Guardian 2

P/G2 Name: *

First

Last

P/G2 Relationship: *

P/G2 Cell Number: *

P/G2 Work Number: *

P/G2 Email: *

P/G2 Home Number: *

P/G2 Employer: *

Primary Phone belongs to: *

Parent/Guardian 1 Cell Parent/Guardian 1 Home Parent/Guardian 2 Cell Parent/Guardian 2 Home

Primary Email belongs to: *

Parent/Guardian 1 Parent/Guardian 2

in case of emergency

Child's health

This health history is correct as far as I understand, and the person herein described, is free of potential health problems which might restrict his or her participation in the BSLC Preschool (except as noted). In the event I cannot be reached in an emergency, I hereby give permission to the physician, hospital, clinic selected by the preschool director/teacher to treat, hospitalize, secure proper anesthesia, injections or surgery.

(Full name & DOB typed in will be your signature)

Does the child regularly attend church? *

Beautiful Savior Lutheran Church (BSLC) Another Church No

Are you members of a church? *

Name of Other Church Affiliation: *

Just put "None" if you have no Church affiliation.

Are you interested in finding out more about BSLC? *

Brothers & Sisters

Note: The $75.00 non-transferable, non-refundable registration/supply fee can be either given by check to Beautiful Savior Lutheran Church, 9800 SE 92nd Ave, Happy Valley, OR 97086 or pay online by clicking the button below.
(Once your child is registered, you can set up a monthly payment via RebelGive, which makes it easy to pay. You can pay online through your bank account or debit/credit card. The following cards are accepted.)
If a specific class is indicated as full, your child will be put on a waiting list and you will not need to pay the $75 until there is an actual opening for your child.

Registration Information

PARENT/GUARDIAN 1

Parent/Guardian 2

in case of emergency

Child's health

Brothers & Sisters