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MoBa - Hybrid In Person/Online Mothering Group
Park Days are the 1st Saturday morning of the month. Zoom meetings are weekly at 12:30 pm PT. To register, please fill out this form - thank you!
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Date
MM
/
DD
/
YYYY
Name (First and last)
Your answer
Email
Your answer
Phone (cell)
Your answer
Where you live: City, State
Your answer
What is your baby's name? How old is your baby?
Your answer
Which type of meeting are you planning to attend?
Online Zoom only
In Person Park Day only
Online and Park Day
Not sure yet
Other:
Clear selection
For Park Day registrants only: Are you vaccinated for Covid-19?
Yes
No
Clear selection
Which format of attendance do you prefer?
Drop in ($15 per session)
2 Week bundle ($25.00)
3 Week Bundle ($35.00)
4 Week bundle ($45.00)
6 Week bundle ($70.00)
Clear selection
What month are you planning to attend? (It's fine to choose one or two and continue on as works for you)
June
July (3 zoom meetings in this month)
August
September
October
November
December (3 zoom meetings in this month)
Clear selection
How would you like to pay?
Venmo (@susanmartiemartin)
PayPal (naturalbeginningsla@gmail or I can send an invoice)
CashApp($susanmariemartin)
Zelle (310-359-3485 or
naturalbeginningsla@gmail.com
)
Other:
Clear selection
Are there any topics of discussion that you are particularly interested in?
Your answer
Any requests or anything else you want me to know?
Your answer
How did you find out about the MoBa Group?
Your email/newsletter
Referral from my doula/midwife
Referral from mom in the group or a friend
Facebook/Instagram
Group member
Other:
Clear selection
I look forward to being with you on Saturdays! I'll be in touch soon. Warmest, Susan
Your answer
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