MOPs Registration - 2022-2023

Member Information

Name

This address will receive a confirmation email

Phone

Address

Birthdate

Husband's Name (if applicable)

MOPs Kids Registration

Please enter information for each child who you expect will be accompanying you to MOPS meetings. You do not need to give us information about older children.

1st Child (full name)

1st Child Birthdate

1st Child - Special Needs (allergies, etc.)

2nd Child (full name)

2nd Child Birthdate

2nd Child - Special Needs

3rd Child (full name)

3rd Child Birthdate

3rd Child - Special Needs

4th Child (full name)

4th Child Birthdate

4th Child - Special Needs

Emergency Contact - Name

Emergency Contact - Phone Number

Emergency Contact - Relationship

Registration Fee

Register with Immanuel Lutheran Church to attend our meetings for $50 for the entire year. Visit www.mops.org/join and have access to online materials (including online meetings and speakers), and a monthly magazine.

Payment 50.00

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Thank you for registering for MOPs at Immanuel!

Registration for MOPs at Immanuel is $50 for the 2022-2023 year which includes your MOPs International Membership.

If you have any questions, please email mops@immanuelrapids.com, or contact Hannah Hall at (715) 972-3147.

We do not want money to prevent anyone from being a part of our community! To that end, there are scholarships available upon request. If you need a scholarship, please reach out to Hannah Hall before submitting your registration form.

MOPs Registration - 2022-2023

Description

Please Fix the Following