North Toronto MOMS Registration 2018/2019
Name (First and Last) *
Your answer
Date of form completion *
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Address *
Your answer
Telephone Number *
Your answer
Email Address *
Your answer
Are you a new member? *
What is the name of your first child? *
Your answer
What is his/her date of birth? *
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DD
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What is the name of your second child (if applicable?)
Your answer
What is his/her date of birth?
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DD
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What is the name of your third child (if applicable)?
Your answer
What is his/her date of birth?
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DD
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Please select a membership category. See details at northtorontomoms.com/membership. *
Please select a babysitting package (available for children 0-4 years of age.) See details at northtorontomoms.com/babysitting. *
How will you pay for your membership and/or babysitting package? Please submit payment as soon as possible in order for your membership to take effect. *
Please select any interest groups that you would like to be a part of:
If you would like to participate in a weekly playgroup, what would best suit your needs at the time of filling out this form?
How did you hear about us? *
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Please read the following: *
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