2022 Hollister MOPS Registration

1

Your Info 👩* This field is required.

First Name

Last Name

Email

Phone

Your Birthday! ✨

Marital Status

2

Husband’s Name* This field is required.

3

Current Address 📌* This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

4

Do you currently attend church?* This field is required.

Yes, I attend South Valley Community Church

Yes, I go to another church in my community.

No, I do not attend church but would like info about South Valley Community Church.

No, I do not attend church and would not like any info.

5

What is the name of the church you attend?

6

Will you require childcare?* This field is required.

YESNO

7

Please list your children who will be needing childcare: 👩‍👦To add another row, press the blue button

8

Have you attended a MOPS group before? 🤗* This field is required.

YESNO

9

Where did you attend MOPS? * This field is required.

10

MOPS Registration Fee* This field is required.If childcare is needed, the fee is $70, if none, $50.

My Bag

0

Hollister MOPS Membership SEMESTER FEENo Childcare Needed
$50.00+Edit
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Hollister MOPS Membership SEMESTER FEE (Childcare)
$70.00+Edit
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First Name

Last Name

Credit Card Number

Security Code

Card Expiration

12

Interested in being a MOPS Mentor Mom? 💕* This field is required.If so, information will be emailed to you.

YESNO

13

Are you interested in volunteering for the MOPS Leadership team?💙* This field is required.If so, information will be emailed to you.

YESNO

14

Please verify that you are human* This field is required.

15

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