A Program of Dharma Rain Zen Center
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Frog Song Fall Enrollment – Fall 2026

Step 1 of 8 – Children Info

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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)
MM slash DD slash YYYY
Gender(Required)
Is this child currently enrolled in Frog Song (Returning Student)?(Required)
Would you like to register a second child?(Required)
Second Child's Name(Required)
MM slash DD slash YYYY
Is second child currently enrolled in Frog Song (Returning Student)?(Required)

Parent Info

Please enter the parent names, emails, and phone numbers below.
Parent Name (1)(Required)
Mailing Address (1)(Required)

Please enter the second parent’s info below.
Parent Name (2)
Mailing Address (2) If different…

People who are Authorized to pickup up the child (other than parents listed above)

Name (1)
Name (2)

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 have copies sent of tests or evaluations that your child has taken.

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 have copies sent of tests or evaluations that your child has taken.

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.
Please select one of the following tuition options for your student(s):(Required)

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.
Note: If child will require medication during school hours, a Medication Authorization form must be completed.

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.
Note: If child will require medication during school hours, a Medication Authorization form must be completed.

Medical Providers

Emergency Contact Information

Authorized Adults whom we should contact if we cannot reach parents/guardians in an emergency.

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.
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.
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.
Sunscreen (Frog Song uses Babyganics brand sunscreen)(Required)
I authorize Frog Song to administer sunscreen to my child as needed.
Neighborhood Walks(Required)
I authorize Frog Song to take my child on neighborhood walks
License(Required)
I have reviewed the license of this childcare facility

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)
Which student(s) would you like to register?(Required)
Please note that there is a $35/student registration fee for Summer Camp.
Please select one of the following summer camp tuition options for your student(s):(Required)

Payment

Your total reflects the registration fee for each new ($200) or returning ($100) student and any additional fees for summer camp.
Payment Method(Required)
To pay online, choose the Paypal or Credit Card option. To pay in-person, choose check.
Choose Credit Card or Paypal
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
 

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.