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Dharma Rain Zen Center
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Frog Song Fall Enrollment – Fall 2026
Step
1
of
8
– Children Info
12%
Instagram
This field is for validation purposes and should be left unchanged.
It may be helpful to gather the following documents before starting this application: Names and numbers of emergency contacts and other adults that can pick up your child, Doctor, dentist, allergy and medication info, Insurance provider and policy number. Thanks!
Child Name
(Required)
First
Middle
Last
Nicknames
Date of Birth
(Required)
MM slash DD slash YYYY
Gender
(Required)
Female
Male
Is this child currently enrolled in Frog Song (Returning Student)?
(Required)
Yes
No
Would you like to register a second child?
(Required)
Yes
No
Second Child's Name
(Required)
First
Last
Date of Birth
(Required)
MM slash DD slash YYYY
Is second child currently enrolled in Frog Song (Returning Student)?
(Required)
Yes
No
Parent Info
Please enter the parent names, emails, and phone numbers below.
Parent Name (1)
(Required)
First
Last
Parent Email (1)
(Required)
Parent Phone (1)
(Required)
Mailing Address (1)
(Required)
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Employer and Occupation
(Required)
Please enter the second parent’s info below.
Parent Name (2)
First
Last
Parent Email (2)
Parent Phone (2)
Employer and Occupation
Child Lives with whom?
Mailing Address (2) If different…
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
People who are Authorized to pickup up the child (other than parents listed above)
Name (1)
First
Last
Phone (1)
Relationship (1)
Name (2)
First
Last
Phone (2)
Relationship (2)
How did you hear about Frog Song Montessori Preschool?
New Student Info
The following information will help us get to know your child better. If you are enrolling more than one new student, this section is for the first student enrolled.
Please list any school or childcare that your child has previously attended:
(Required)
What benefits do you hope your child will experience by attending Frog Song Montessori Preschool?
(Required)
How do you see yourself/your family supporting your child's preschool experience?
(Required)
Does your child have any special interests, capabilities or talents?
(Required)
How do you see your child in their social and emotional development?
(Required)
Please describe your child's social experiences thus far. What has been successful? What has been challenging?
(Required)
Does your child have any special needs (educational, medical or psychological)? Has your child received any testing or evaluations that would relate to their academic or social performance?
(Required)
Please have copies sent of tests or evaluations that your child has taken.
Are there any areas in which we may be able to give special help and encouragement to your child?
(Required)
What are your child's general likes and dislikes?
(Required)
Describe your child's eating habits and schedule:
(Required)
Describe your child's sleeping habits and schedule:
(Required)
How does your child like to be comforted?
(Required)
Are there family or cultural backgrounds, traditions, beliefs or interests that you would like to share with us?
(Required)
What is your child's home language?
(Required)
Please list the other children in your home (name, age, school, anything else you would like to share).
(Required)
New Student (2) Info
The following information will help us get to know your child better. This information is for the second child you are enrolling.
Please list any school of childcare that your child has previously attended:
(Required)
What benefits do you hope your child will experience by attending Frog Song Montessori Preschool?
(Required)
How do you see yourself/your family supporting your child's preschool experience?
(Required)
Does your child have any special interests, capabilities or talents?
(Required)
How do you see your child in their social and emotional development?
(Required)
Please describe your child's social experiences thus far. What has been successful? What has been challenging?
(Required)
Does your child have any special needs (educational, medical or psychological)? Has your child received any testing or evaluations that would relate to their academic or social performance?
(Required)
Please have copies sent of tests or evaluations that your child has taken.
Are there any areas in which we may be able to give special help and encouragement to your child?
(Required)
What are your child's general likes and dislikes?
(Required)
Describe your child's eating habits and schedule:
(Required)
Describe your child's sleeping habits and schedule:
(Required)
How does your child like to be comforted?
(Required)
Tuition
Registration fee is $100 for returning students and $200 for new students. Your registration fee is due at the time of registration. Tuition will be due by September 1st, 2026. A 3% discount will be given for full tuition payments made prior to September 1, 2026. Tuition may be paid in ten monthly installments, due by the 1st of each month, September to June. If tuition is paid after the 5th day of the month, a late fee of $25 will be assessed, unless prior arrangements have been made with the administrative coordinator. Students whose tuition is 30 days past due may not continue to attend Frog Song Montessori Preschool except by arrangement with the administrative coordinator. Monthly tuition invoices will be distributed on the 25th day of each month. Tuition may be paid by check deposited in the tuition box in the classroom, or by PayPal on our website. A charge of $30.00 will be assessed for any returned checks.
Registration Fee – New Student (1)
Price:
Registration Fee – New Student (2)
Price:
Registration Fee – Returning Student (1)
Price:
Registration Fee – Returning Student (2)
Price:
Please select one of the following tuition options for your student(s):
(Required)
Regular Day (8:30-2:30pm M-Fr) $1,260/mo
Extended Day (8:30-5:00pm M-Th, 8:30-2:30pm Fr) $1,730/mo
Partial Extended Day (8:30-5:00pm M/Tu) $1,495/mo
Partial Extended Day (8:30-5:00pm W/Th) $1,495/mo
Health information (First Student on enrollment form)
Allergies and medical conditions. If you are filling out this form for more than one student, this question is for the FIRST student on the form.
Does your child have allergies?
(Required)
If you are filling out this form for more than one student, this question is for the FIRST student on the form.
Yes
No
Please describe your child's allergies
(Required)
Please describe any health conditions and instructions for providing best possible care in regard to these conditions. Also note if health conditions restrict child's activities.
Note: If child will require medication during school hours, a Medication Authorization form must be completed.
List of Current Medications
Health information for Second Student
If you are filling out this form for more than one student, this section is for the SECOND student on the form.
Does the second child on this enrollment form have allergies?
(Required)
If you are filling out this form for more than one student, this question is for the SECOND student on the form.
Yes
No
Please describe your child's allergies
Please describe any health conditions and instructions for providing best possible care in regard to these conditions. Also note if health conditions restrict child's activities.
Note: If child will require medication during school hours, a Medication Authorization form must be completed.
List of Current Medications
Medical Providers
Insurance Provider:
(Required)
Policy Number
(Required)
Name of Child's Physician
(Required)
Physician's Phone Number
(Required)
Physician Address
(Required)
Date of last physical exam
Name of Dentist
(Required)
Dentist's Phone Number
(Required)
Dentist Address
(Required)
Date of last dental exam
Emergency Contact Information
Authorized Adults whom we should contact if we cannot reach parents/guardians in an emergency.
Name
(Required)
Phone
(Required)
Relationship
(Required)
Name
(Required)
Phone
(Required)
Relationship
(Required)
Name
Phone
Relationship
Consents and Waiver
Consent to Medical Treatment
(Required)
I hereby give permission that my child may be given emergency treatment to include first aid and CPR by a qualified staff member at Frog Song Montessori Preschool. I further authorize and consent to medical, surgical and hospital care, treatment and procedures to be performed by my child’s regular physician, or when that physician cannot be reached, by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health and I cannot be contacted. I waive my right of informed consent to such treatment.
I also give my permission for my child to be transported by ambulance or aid car to an emergency center for treatment.
I give my consent to medical treatment
Liability
(Required)
At Frog Song every precaution is taken to assure your child’s safety while in our care.
I agree to release and forever hold harmless DRZC and its successors from any and all liability, claims and demands which arise or may hereafter arise from visits to DRZC. I understand and acknowledge that this Release discharges DRZC from any liability or claim that I may have against DRZC with respect to bodily injury, personal injury, illness, death or property damage that may result from my child’s participation in Frog Song activities or occurring while on the property of DRZC known as Siskiyou Square.
I understand that my child will engage in activities in a natural environment and that Siskiyou Square is an active construction site. I assume all risks associated with their participation in this program.
I express my understanding and intent to enter into this Release and Waiver of Liability willingly and voluntarily.
Photography Consent (optional)
(Required)
DRZC has permission to take photographs of my child. I give model release for the use of any photos on the DRZC website or in printed materials. I further understand that photos may be taken of my child by others. By checking ‘yes’ below, I give consent to this photography release.
Yes
No
Sunscreen (Frog Song uses Babyganics brand sunscreen)
(Required)
I authorize Frog Song to administer sunscreen to my child as needed.
Yes
No
Neighborhood Walks
(Required)
I authorize Frog Song to take my child on neighborhood walks
Yes
No
License
(Required)
I have reviewed the license of this childcare facility
Yes
No
Immunizations
Please complete the Oregon Certificate of Immunization Status form. Oregon law requires proof of immunization be provided or an exemption signed prior to a child’s attendance at preschool. A link to the form will be provided in your confirmation email. Please print it, fill it out and return it via email to info@frogsongpreschool.org.
Summer School 2026 (Conditional Formatting for Returning Students Only)
Frog Song Summer Camp is four weeks of Bugs, Earth and Fun. Dates are July 6-31st, 2026. You can save your spot now. Current students are given priority for summer camp. If you have a sibling who will be incoming Fall 2026, you are welcome to sign them up. However, we cannot guarantee there will be a spot available until we hear back from all of our current students. We will reach out in March to confirm availability.
Would you like to register a student for Summer Camp 2026?
(Required)
Yes
No
Which student(s) would you like to register?
(Required)
Please note that there is a $35/student registration fee for Summer Camp.
First Student – $35 registration fee
Second Student – $35 registration fee
Both Students – $70 registration fee
Please select one of the following summer camp tuition options for your student(s):
(Required)
Regular Day (8:30-2:30pm M-Fr) $1,190
Extended Day (8:30-5:00pm M-Th, 8:30-2:30pm Fr) $1,635
Partial Extended Day (8:30-5:00pm M/Tu) $1,413
Partial Extended Day (8:30-5:00pm W/Th) $1,413
Payment
Your total reflects the registration fee for each new ($200) or returning ($100) student and any additional fees for summer camp.
Total
Payment Method
(Required)
To pay online, choose the Paypal or Credit Card option. To pay in-person, choose check.
Paypal or Credit Card
Check
Choose Credit Card or Paypal
PayPal Checkout
Credit Card
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number
Expiration Date
Security Code
Cardholder Name
Pay by Check
For checks, please make the check payable to Dharma Rain Zen Center and note ‘Frog Song Registration’ in the memo field. You may mail this to: Dharma Rain Zen Center, 8500 NE Siskiyou St., Portland, OR 97220, OR contact Claire or Jen to arrange a drop-off.