MOMS Club of LaPorte / New Prairie, IN Membership Form

MOMS® Club is an international non-profit organization with hundreds of chapters across the globe. We are a support group for mothers, with children at home, who are looking to connect with other mothers in their community.

We strive to offer opportunities for mothers to connect and support one another, feel relevant, and contribute to local initiatives without the pressure of finding babysitters, paying for childcare, or feeling embarrassed for bringing crying babies or energetic children to events. We are an inclusive group and support mothers from all backgrounds and parenting approaches.

Facebook:

https://www.facebook.com/MOMSClubLP/

Website:
https://laportemomsclub.wordpress.com

Email:

laportemomsclub@gmail.com

By laws:

https://drive.google.com/file/d/12qlXRYH0oDz3Rv7o7g2NMEsDzYVj08K_/view?usp=drivesdk

Joining is easy!

To join, fill out the form below, then we will reach out collect annual membership dues.

No mothers will be denied membership because of costs, so please ask if you need financial support.

We look forward to seeing you at our upcoming events!
Enter Your Name

First NameLast Name
Enter Your Address

Street Address

Street Address Line 2

CityState

Zip Code
Cell Phone Number

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Enter Your Email Address
example@example.com
Enter Your Birthday (MM/DD)
You only need to enter the month and date. Birth year is not required.
Enter Your Child(ren)'s Name and Birthdate(s) (MM/DD/YY)
Enter One Child and Birthday Per Line
Does Your Child (or Children) Have Any Allergies?
If Yes, Please List The Child's Name and Allergies
How Did You Hear About Us?
Have You Ever Been a Member of This Or Any Other Mom's Club?
If Yes, Please List Which Chapter
Do You Enjoy Any Volunteer Work?
If Yes, Please List Where
May we share photos of you and/or your child? This includes marketing documents or on social media
Click here to opt-in for text messages from the club - typically for event reminders. You can opt-out at any time.
Membership Information and Liability Release

All members must sign have a liability release on file with the local MOMS Club before attending any activities or programs.
Please read and sign the liability release information below. You may not become a member until it is signed. Thank you.

Liability Release
I, the undersigned, understand that my participation and the participation of any members of my family in any MOMS Club activity or program is completely voluntary, and we hereby give permission for myself and my family to join in those activities or programs. My family shall hold harmless this local MOMS Club, the MOMS Club Corporation, and MOMS Club volunteers or representatives, paid or unpaid, and/or the providers of any activity or program location and/or materials from any liability and/or responsibility for any accident, illness or injury that occurs during or as a result of any function or program. I accept that the final responsibility for my safety and that of my family rests with me.
Please read the MOMS Club of LaPorte / New Prairie, IN Code of Conduct
Member's Signature acknowledging that you have read and accept the Liability Release and MOMS Club Code of Conduct

Use finger/mouse to sign in the box above
Today's Date

MonthDayYear
Date
Please verify that you are human
TO PAY FOR MEMBERSHIP CLICK HERE
Should be Empty:

Membership Information and Liability Release