Gayton Baptist Church MOPS/MOMSnext Registration
Answers marked with a * are required.
Annual Membership Fee: $40.00 for MOPS or MOMSnext, $60 for both (scholarships available)
Please make check payable to Gayton Baptist Church with MOPS in the memo line.
Mail check to GBC, 13501 N Gayton Rd, Henrico, VA 23233, attn: MOPS
First meeting: Monday, September 13, 7 PM (MOPS), Monday, September 27, 7 PM (MOMSnext)
Welcome to MOPS & MOMSnext at Gayton Baptist Church! Please complete this form so we can learn some basic information about you.
1.
Registration for:
MOPS (Mothers of Preschoolers)
MOMSnext (Mothers of Elementary School Age Children)
Both MOPS & MOMSnext
2.
First Name
*
3.
Last Name
*
4.
Middle Initial
5.
Street Address
*
6.
City
*
7.
Zip
*
8.
Home Phone
*
9.
Work or Cell Phone
10.
Birthday
11.
E-mail
*
12.
Husband's Name (if applicable)
13.
Have you attended a MOPS group before?
Yes
No
14.
If so, where?
15.
Do you attend church?
*
Yes
No
16.
If so, where do you attend?
17.
How did you hear about this MOPS/MOMSnext Group?
18.
Please list your children's names and dates of birth
First Child
Second Child
Third Child
Fourth Child
Fifth Child
19.
Refer a friend and we'll send her information on how she can attend MOPS or MOMS Next
Name
Phone
Address
Email
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