Brooklyn Daytime Group

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Thank you for your registration of interest for the Mothers Network Brooklyn Daytime Group, running from Tuesday 18th October-Tuesday 22nd November from 10am-12pm. 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.

Email *

First and Last name *

Preferred name *

Phone 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*

Required

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 (if you can!) 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?

Submit

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