Millennial Moms Club Registration Form

Millennial Moms Club Registration Form

Fridays at 12pm EST starting 11/1/24
The fall group will run for 7 weeks and will be held every Friday at 12pm EST starting November 1 through December 20. All groups will be 75 minutes via Zoom.

Groups will be held 11/1/24, 11/8/24, 11/15/24, 11/22/24, 12/6/24, 12/13/24, 12/20/24 (there will be no group the week of Thanksgiving 11/29/24).
Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Pronouns
E-mail
example@example.com
Mobile Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What topics are you hoping to discuss in this group?
What are you hoping to gain from this group?
Group Rules

1. This a closed, private space. Please be careful to not share any identifying information about the participants outside of the group (including names, locations, health information, etc).

2. All groups are fat-positive and weight-inclusive. While of course body image conversations may explore the desire to change your body or the discomfort in your current body, the goals of this group will not involve weight loss and body modification and will rather focus on ways to care for your body. I ask that you not share specific numbers like weights or calories as that can be triggering for some people. Weight or body shaming of other members will not be tolerated and will result in your removal from the group.

3. All groups are LGBTQ+ affirming. Any homophobia, transphobia, etc will not be tolerated and will result in your removal from the group.

4. This is not a replacement for individual nutrition therapy. While I am happy to offer insights and general strategies, this is not medical advice. If you are looking for one-on-one counseling in addition to or in place of group support, I'm happy to help you find an appropriate provider.
I have read and agree to the group rules.

My Products

Millennial Moms Club Weekly payments - pay for the first week now and pay weekly starting 11/8

$40.00 Quantity

Millennial Moms Club membershipOne time payment

$249.00 Quantity

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Millennial Moms Club Registration Form

The fall group will run for 7 weeks and will be held every Friday at 12pm EST starting November 1 through December 20. All groups will be 75 minutes via Zoom.