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Name *
Mobile Number *
List Social Media Sites *
Address *
City *
Gender *
Tell us about your entrepreneurial interests:
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Select which membership you're applying for:
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Select other interests:
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Have you ever participated in any entrepreneurship-related activities or projects? If yes, please describe.
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Are you in need of financial assistance to participate in the program? If yes, please explain your circumstances.
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Emergency Contact:
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Who recommended you; How did you hear about us?; (PLEASE LIST ANY NAMES AND/OR PROMO CODES YOU MAY HAVE)   *

Media Release Consent:

I hereby grant permission for photographs and videos of me taken during the M.O.B Program to be used for promotional and educational purposes. I understand that my personal information will not be shared without my consent.

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I certify that the information provided in this application is true and accurate to the best of my knowledge.

Membership Fees: a. The Member agrees to pay the applicable membership fees as outlined in the selected tier.

Program Participation: a. The Member commits to actively participate in and abide by the guidelines and code of conduct outlined by M.O.B. b. Any violation of program guidelines may result in the termination of membership.

Release and Disclaimer: a. The Member acknowledges and agrees that M.O.B, its organizers, and affiliates are not responsible for any interactions, collaborations, or events that occur between members outside the official program activities and channels. b. By participating in M.O.B, the Member releases M.O.B, its organizers, and affiliates from any liability, claims, or responsibilities related to actions or events that occur independently among members outside the defined program structure.

5. Termination: a. M.O.B reserves the right to terminate a member's participation for violation of program guidelines or any other reason deemed necessary by M.O.B.

6. Miscellaneous: a. This Agreement constitutes the entire understanding between M.O.B and the Member, supersedes all prior agreements, and may only be amended in writing. b. This Agreement is governed by the laws of Georgia.

By checking the box below, I acknowledge and agree to the terms outlined in this Membership Agreement, including the Release and Disclaimer.


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