2023 Single Mum's

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2023 Single Mum's - Karori

Thank you for your registration of interest for the Mothers Network Single Mum's group, running from Saturday 18th February - Saturday 25th March from 10.30am-12.30pm. Please note this is not a confirmation, you will be sent a confirmation email separately

Please fill in all information below and we will contact you as soon as possible to confirm.

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電子郵件 *

First and Last name *

Preferred name *

Best contact number *

Do you require childcare during the group? *

Yes

Please insert name/s and age/s of children requiring childcare (re: above)

Do you have any dietary requirements? *

Gluten Free

Dairy Free

Vegan

Vegetarian

Other*

必填

If you selected 'Other' please specify below

The course runs for six weeks and to get the most out of the group it is best to attend all six weeks. *

I acknowledge that the group runs for 6 weeks

It is helpful for us to know if you can contribute to our group cost (NB this is not a requirement, you can still attend) *

Yes, I can contribute the full $60 ($10 per week)

Sorry, I am not able to at this time

I can contribute another amount (higher or lower)

Anything else you would like us to know?

Ethnicity (Used for statistical purposes only)

What is your date of birth? (Used for statistical purposes only)

How did you find out about us?

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