Rogers MOPS Registration 2017-18
First Name *
Last Name *
Birthdate
MM
/
DD
/
YYYY
Address *
City *
State *
Zip Code *
Phone Number *
Email Address *
Have you attended a MOPS group before? If yes, where?
Do you have a home church? *
If yes, where do you attend regularly?
Our group communicates information via email and Facebook. Do you regularly use Facebook? *
Do you have a spouse that travels often?
Clear selection
If yes, would you like to be connected to other moms with traveling spouses?
Clear selection
What are the names/ages of your child(ren)? *
Will you be bringing any children to the meeting? *
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