Online Preschool Registration

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

Please mark the session for which you are registering: *

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

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

This primary cell phone can receive text message reminders about upcoming events, deadlines, and schedule changes. *

Yes No

Primary Cell Phone Carrier: (AT&T, Sprint, Verizon, etc.) *

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.

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: Those on the waiting list will not be asked to pay the $75 until there is an actual opening for your child.
The $75.00 non-transferable 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.)

Registration Information

PARENT/GUARDIAN 1

Parent/Guardian 2

in case of emergency

Child's health

Brothers & Sisters