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River West - MOPS (Mother's of Preschoolers)
MOPS Registration 2018-2019
Welcome! Please complete this form so we can learn about you!

River West Group Fees for 2017-2018
• No Childcare/Lap Babies (children under 6 months) - $165/year
• Mom and 1 Child - $250/year
• Mom and 2 Children - $350/year
• Mom and 3-4 Children - $400/year

*Children under 6 months are considered lap babies and do not require childcare. Once a child is 6 months we are required to hold a spot for them in care and will charge childcare fees.
*You may pay semi-annually (September & January) via eTransfer (give@riverwestchurch.org). Please send the answer to your security question to office@riverwestchurch.org. You may also pay with post-dated cheques (due at start of MOPS), or a lump sum payment (cash or cheque). Please make all cheques payable to River West Christian Church.
*Please note that your spot in MOPs will not be held for you until payment has been received.

For more information please contact the church office at office@riverwestchurch.org or 780-487-2275

Your Contact Information
First Name *
Your answer
Last Name *
Your answer
Home Phone *
Your answer
Alternate Phone
Your answer
Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Email *
Your answer
Birthday
MM
/
DD
Your MOPS Information
Have you attended a MOPS group before? *
If "Yes", Where?
Your answer
Home Church
Your answer
How did you hear about this MOPS group?
Your answer
Your Family Information
Please List Your child(ren)'s name(s) and birthdate(s) & Gender: *
Your answer
Husband's name (if applicable)
Your answer
Does your child(ren) have any medical conditions or allergies?
If "yes" please list child and condition
Your answer
Is there anyone that DOES NOT have permission to pick up your child (i.e. custody situation)? If so, please provide their name
Your answer
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