Club Membership Registration Form

MOYC Membership Registration

Complete the form below to sign up for our bi-monthly meetings, mom's nights out and more.
Name

First NameLast Name
E-mail
example@example.com
Phone Number:

Area CodePhone Number
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Birth Date:

MonthDayYear
Please list Names and Ages of your Children

Childcare available for children 6 months and older. Babies are welcome to join meetings.
Child 1

NameAgeChildcare needed?
Child 2

NameAgeChildcare needed?
Child 3

NameAgeChildcare needed?
Child 4

NameAgeChildcare needed?
Child 5

NameAgeChildcare needed?
Child 6

NameAgeChildcare needed?
Playgroup Interest and Availability

Playgroups will be smaller groups that meet weekly or monthly depending on each group's specific needs. We will aim to create groups of similar aged children that can meet up at parks or homes get to know each other outside of scheduled meetings.
Babies- weekday morningsToddler- weekday morningsPreschooler- weekday morningsElementary- weekday afternoonsBabies- weekendsToddler- weekendsPreschooler- weekendsElementary- weekendsNot Interested at this time
Book Club Interest
Book Club will meet once a week in the evening to discuss the book Finding Calm in the Midst of Chaos
InterestedNot Interested
Membership Dues
MOYC membership costs $50 per semester to attend meetings. Childcare is provided for children 6 months and older. Babies are welcome in the meetings.

Childcare dues, per semester, are

1 child: $20

2 or more children: $35

To pay annual dues, pay for childcare, or send a donation click below.

Pay Dues

*Financial assistance is available on a need basis, please contact erinvankirk@gmail.com
Once you submit your application and payment, we will contact you about our upcoming meetings.
Should be Empty:

MOYC Membership Registration

Please list Names and Ages of your Children

Playgroup Interest and Availability

Book Club Interest

Membership Dues