Mothers On Mission Registration 2022-2023
Welcome to Mothers On Misson (formerly known as MOPS)! Please complete this form so we can learn some basic information about you. Our MOMs dues for the full year is a total of $125. $75 paid in the fall and $50 paid in the spring. Check or cash can be paid by mail to First Baptist Church Amarillo at 1208 S. Tyler, Amarillo, TX 79101 or can be brought to your first meeting. We also have the option to pay by credit card at the first few meetings. Scholarships are available. Contact Allyson Kaplan at momsamarillo@gmail.com or 806-674-4885 for more information. First meeting information, childcare forms, and a meeting schedule will be sent via email by mid-August. MOMs first meeting will be September 7th.
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First and Last Name *
Street Address *
City *
Zip *
Cell Phone *
E-mail Address *
Birthdate *
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Have you attended MOMS (MOPS) Amarillo before? *
Required
If the answer is 'no' to the previous question, have you attended a MOMS group elsewhere? If so, where?
Do you attend a local church? If so, where? *
How did you hear about this MOMS group? *
Please list ALL of your child(ren)'s NAMES and BIRTHDATES:
Please list YOUNGEST to OLDEST. We use this information for our childcare classes.  
For example: Jonathan Smith 02/22/2015
Child #1 NAME (youngest child): *
Child #1 BIRTHDATE *
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Will Child #1 need childcare during MOMS? *
Child #2 NAME
Child #2 BIRTHDATE
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YYYY
Will Child #2 need childcare during MOMS?
Clear selection
Child #3 NAME
Child #3 BIRTHDATE
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YYYY
Will Child #3 need childcare during MOMS?
Clear selection
Child #4 NAME
Child #4 BIRTHDATE
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YYYY
Will Child #4 need childcare during MOMS?
Clear selection
Child #5 NAME
Child #5 BIRTHDATE
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Will Child #5 need childcare during MOMS?
Clear selection
Please list any additional children here with birthdate.
Are you expecting a new baby? If so, what is your expected due date? *
If you would like to order a MOMs t-shirt (proof to come); please list your size (true-fit, unisex). T-shirts will be $15 and can be paid with dues, or at the first meeting.
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If you have interest in serving on The Steering Committee (our leadership team), please select your position(s) preference.
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