2021 Moms in the Making Conference Registration Form

You are invited to join us for a Moms in the Making Night of Ministry for Couples!

Who is this for?

This event is open to anyone who has received an infertility diagnosis and is currently trying to expand their family. Are you currently pregnant or do you have miracle babies at home? You are invited too! We encourage you to bring your husband with you, but if he can’t make it, you are still welcome to join us!

Ticket Prices

$15/person

$25/couple
Contact Information
Your Name*

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

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip CodeCountry
As of today, where are you in your journey to become a mother? Please check all that apply.*

Currently Trying to Grow My FamilyMiracle(s) Baby(ies) at HomeCurrently PregnantAttending as a support roleOther
How did you find out about this event?*

My Moms in the Making Support GroupSocial MediaNewsletterWord of MouthOther
Do you attend a local support group? *
Are you bringing your spouse?*
If so, what is their name?
Amount
I understand that there are no refunds excepted.*

I agree
By purchasing this ticket, I hereby waive Moms in the Making from any liability and/or claim for personal injury, property damage, sickness, or death that may arise from attending this event. I hearby agree to indemnify, defend and hold the Releasees harmless from any and all claims, actions, suits, procedures, costs, expenses, damages, and liabilities from my attendance at this event.*

I agree
By entering and attending the event, I consent to be photographed, filmed and/or otherwise recorded. My entry constitutes my consent to such photography, filming and/or recording and to use in any and all media. This might include (but is not limited to), the right to use them in any printed and online publicity, social media, press releases and funding applications and more.*

I agree
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