MOPS Registration 2024

Info

Name

This address will receive a confirmation email

Cell Phone

Address

Do you use Facebook?

Yes No

Best way to contact you

MOM'S Birthdate

Have you attended a MOPS group before?

Yes No

If yes, where?

Are you already registered for the MOPS International Membership?

Yes No

Local church (if you attend a church in the East Bay):

How did you hear about this MOPS group?

Spouse/partner's Name (if applicable)

Spouse/partner's cell (if applicable)

MOPS KIDS Registration

Please list your children who will be in MOPS Kids classrooms during meetings:

Kid #1 Name

Kid #1 Birthday

Kid#2 Name

Kid #2 Birthday

Kid #3 Name

Kid #3 Birthday

Does your child/children have any allergies/special needs/any instructions?:

Alternate Emergency contact (permission to watch your kids), Name:

Their Cell

Membership 120

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Welcome - Please complete this form so we can learn about you!

MOPS Membership Fee …. $34
(You will receive a Welcome Package from MOPS International)
BFCC MOPS Group Fee …. $86
Total ……. $120

“This is motherhood, and together we can change the world in all the best ways.”

MOPS Registration 2024

Description

Please Fix the Following