Adventure Friends Preschool
WELCOME 
Please click on the "registration form" tab to print the registration form.
Mail with registration fee to secure your child's place in Adventure Friends Preschool.
Thank you,
Katie Krueger
****WEBSITE UNDER CONSTRUCTION****
Registration Form
Simply copy this form and mail it in with your registration fee to the address listed.
Adventure Friends Preschool
Katie Krueger BA, MEd.
Lynwood Friends Church
835 SE 162nd Portland, OR 97233
(503) 252-8415
2010-2011 Registration Form
Name of student _________________________________________ M ( ) F ( )
Age______ Birthdate___________________
Please list any allergies, physical or mental disabilities, communicable diseases,
or behavioral problems your child has at this time: ________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Parent Information
Father’s name____________________________________________________
Lives with student: yes___ no___ Can pick up student: yes___ no___
Phone number(s)__________________________________________________
E-mail(s) ________________________________________________________
Address_________________________________________________________
Mother’s name____________________________________________________
Lives with student: yes___ no___ Can pick up student: yes___ no___
Phone number(s)__________________________________________________
E-mail(s) ________________________________________________________
Address_________________________________________________________
Emergency Contact Information:
People we may call if parents are unavailable:
1.________________________________ Phone_________________________
2.________________________________ Phone_________________________
Tuition Information:
Schedule:
October 5, 2010 – June 9, 2011
Tuesdays, Wednesdays and Thursdays 10:00 - 12:00
Extra Hour Wednesdays and Thursdays 12:00 - 1:00
School closure days due to inclement weather will be made up in June.
(Please follow Centennial School District late arrival/closure notices)
Prices:
$120.00 per month (June is $60.00 for a half month)
$70.00 non-refundable registration/supply fee due at time of registration
***If registration is declined by Adventure Friends $70.00 fee will be refunded***
$30.00 supply fee for "extra hour" materials
Payment is due the first Tuesday of each month.
Please make checks payable to Lynwood Friends Church and noted for AFP.
The state requires Adventure Friends have a copy of your child’s immunization records on file. Please provide a copy by October 1, 2009.