SnoCo BIPOC Moms Wellness Mornings

1
Which workshop(s) are you registering for? (select all that apply)* This field is required.
Saturday, May 16, 2026 - Aromatherapy Make and Take (10 am to 12 pm in Edmonds, WA)
Saturday, May 30, 2026 - Creating Rituals for Yourself (10 am to 12 pm in Edmonds, WA)
Saturday, June 6, 2026 - Joy and Rejuvenation (10 am to 12 pm in Edmonds, WA)
Saturday, June 13, 2026 - Jewelry Making (10 am to 12 pm in Edmonds, WA)
2
Moms only with no childcare provided* This field is required.The venue for these workshops is not setup for to be child safe and FOCS is unable to provide childcare.
3
Your First and Last Name* This field is required.
First Name
Last Name
4
Your email* This field is required.
example@example.com
5
Your Phone Number* This field is required.
Include area code
6
Your Races and Ethnicities (select all that apply)* This field is required.
Asian/Asian-American
Black, African, or African American
Indigenous to the Americas/American Indian/Alaska Native
Middle Eastern or North African
Native Hawaiian/Pacific Islander
White/European
Latina/o/x/e
Other
7
Your Gender (select all that apply)* This field is required.
Transgender (doesn't identify as gender assigned at birth)
Cisgender (does identify as gender assigned at birth)
Female
Male
Non-Binary
Agender
Two-Spirit
Fa’afafine
Fa’afatama
Questioning or unsure
Prefer not to say
Unknown
Other
8
Do you have any food allergies or dietary restrictions or needs? If so, please describe.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
9
Do you have any access needs? If so, please describe.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
10
Number of family members 0-17 years old?* This field is required.
11
Number of family members 18-24 years old?* This field is required.
12
Your Zip Code* This field is required.
13
Does anyone in your family (select all that apply):* This field is required.
Live in Seattle
Work in Seattle
Go to school in Seattle
No one in our family lives, works, or goes to school in Seattle
14
Does anyone in your family (select all that apply):* This field is required.
Live in Snohomish County
Work in Snohomish County
Go to school in Snohomish County
No one in our family lives, works, or goes to school in Snohomish County
15
What language(s) would you like to receive services in?* This field is required.Select all that apply
English
Other
16
What language(s) does your family speak at home? (select all that apply)* This field is required.
English
አማርኛ/Amharic
ភាសាខ្មែរ / Khmer
Af-Soomaali / Somali
American Sign Language
Anishinaabemowin / Anishinaabe
Chahta' / Choctaw
Diné Bizaad / Navajo
dxʷləšucid / Lushootseed
Español / Spanish
Filipino
French
Gagana faʻa Sāmoa / Samoan
Lakȟótiyapi / Lakota
Lingala
Łingít / Tlingit
língua portuguesa / Portuguese
Ōlelo Hawaiʻi / Hawaiian
Sahaptin / Yakima
Siksikáí'powahsin / Blackfoot
Tiếng Việt / Vietnamese
vosa vaka-Viti / Fijian
xʷləmi tʃɔsən / Lummi
हिन्दी / Hindi
한국인 / Korean
廣東話 / Cantonese Chinese
普通话 / Mandarin Chinese
Other
17
Household Income* This field is required.This helps us advocate to funders to fully fund our parent support groups!
$20,000 or less
$20,000 - $40,000
$40,000 - $60,000
$60,000 - $100,000
$100,000 - $200,000
Over $200,000
18
Number of People in Your Household* This field is required.
19
How did you find FOCS (select all that apply):* This field is required.
I am a returning FOCS participant
Paper flyer
Word of mouth
Another organization
Social media
Healthcare worker
Google search
Other
20
Data Use Agreement* This field is required.FOCS reports some demographic data and outcomes to our grantors and in our annual reports for the purposes of program evaluation, accountability, and to increase the likelihood of renewed funding. FOCS reports aggregated data only and will never disclose any personal or identifying data without gaining additional written consent.
21
Would you like to get email updates from FOCS?* This field is required.Select 'yes' to subscribe to our monthly newsletter
Yes!
No, thank you.
22
Would you like to receive reminder texts for the programming you are registering for?* This field is required.Select 'yes' to subscribe to our monthly newsletter
Yes!
No
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