2020-2021 Crossroads MOPS Registration

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Name (First & Last) *

Email Address *

Phone Number *

Address *

Birthdate *

YYYY

Are you new to Crossroads MOPS or a returning member? *

Returning member

New member

If returning, what small group were you in last year? *

Would you like to stay in your current small group? *

Yes

N/A--new member

Given the current circumstances and the uncertainties surrounding group gatherings and childcare, how would you feel if we temporarily moved our meetings to Tuesday evenings? Please explain your choice below. *

How did you hear about our MOPS group? *

Home church, if applicable. *

Child #1: Name (First & Last)

Child #1: Date of Birth

YYYY

Child #1: MOPS Childcare Attendance

Child #1: Allergies/Special Needs

Child #2: Name (First & Last)

Child #2: Date of Birth

YYYY

Child #2: MOPS Childcare Attendance

Child #2: Allergies/Special Needs

Child #3: Name (First & Last)

Child #3: Date of Birth

YYYY

Child #3: MOPS Childcare Attendance

Child #3: Allergies/Special Needs

Additional Children

If you have more than 3 children, please list their full names, birthdates, MOPS Childcare Attendance & allergies/special needs
below.

Infant Policy

Babies up to 6 months old can been kept in meetings with you if you prefer. Otherwise, we ask that the child goes to his/her appropriate childcare class so that everyone can get the full benefit of their time at MOPS.

Will you be keeping an infant in the meetings with you? *

Yes

MOPS Dues

Our local MOPS dues are collected in order to cover a variety of costs such as (but not limited to) childcare expenses, printed materials, gifts, donations, craft supplies and scholarships. We have increased your payment options to try an accommodate everyone's needs, and we will be sending out invoices based on the payment plan that you choose.

Choose one of the following payment plans: *

YEAR IN FULL: a one-time (1) payment of $200

SEMESTER PAYMENTS: two (2) payments of $100, paid at the beginning of each semester

MONTHLY PAYMENTS: eight (8) payments of $25, paid on the 1st of the month from September-April

SCHOLARSHIP: I am in need of financial assistance in order to maintain my MOPS membership and would like to be contacted for further information

MOPS International Registration

Please click the link below to be taken to the official MOPS International page. There, you will complete their registration and pay the MOPS International dues that are required in order to be officially registered with our group. It's super easy and only takes a few minutes!

THE CROSSROADS RALEIGH MOPS GROUP CODE IS: H2HU
If you are registering for MomsNext please use code: CXTW

https://www.mops.org/join/

NOTE: Your membership is not complete until this additional registration has been submitted (unless you indicated a scholarship need).

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