2010-11 Registration


Name:
Address
City
State
Zip:
Phone:
Alternative Phone:
Email Address:
Birthday: (month/day is fine)
CHILD 1 Name/Age
CHILD 2 Name/Age
CHILD 3 Name/Age
CHILD 4 Name/Age
CHILD 5 Name/Age
CHILD 6 Name/Age
Service Opportunities Hospitality (decorations, setup, food table)

Childcare (registration, room mother, childcare worker)

Family Activities / Crafts (help with preparation of projects)

Publicity
How did you hear about Moms & More?

After submitting this registration form, you will be redirected to the payment page. A $10.50 fee will hold your spot & help with startup costs of Moms & More. If you have questions or would rather pay by check, please contact Deanna Mason at 708-429-7729.