Six Mile MOPS                                                     Registration Form 2023 - 2024
Motherhood is hard, but it does not have to be lonely. Caring for our kids involves the unique combination of fulfillment and utter frustration. You might feel inadequate, isolated, lonely or just totally exhausted. But you don’t have to struggle through the challenges alone. Six Mile MOPS is open to all women who desire encouragement and friendship with other moms.

We meet twice a month while our children are cared for by loving helpers. In order to help with some of the operating expenses our group collects a fee. It is $120/year which is split into 2 payments: $60 September dues and $60 January dues. The fee covers the required MOPS International membership ($34), crafts, childcare snacks, MOPS kids crafts and a portion of the childcare costs.

To register, please fill out this form and submit a semester's or year's fee to secure a spot for you and your children as needed. When our childcare spots are full, we will have a waitlist available.

Payment:

- The easiest way to pay is to Venmo Pat Manderschied at @Patricia-Manderschied
or by:
 - Electronic checks on https://portal.icheckgateway.com/fmefree/
Click on "Donate with a check"
Fill out information
Make sure to write “MOPS” in the memo line
- Cash/Check. Can be given to Haley Henahan (Coordinator), Katelyn Van Scoy (Coordinator) or 
Pat Manderschied (Mentor Mom).
 Please make your check payable to FMEFC, write in memo line "MOPS".

 If Mailing:
Fort Myers Evangelical Free Church
Attn: Six Mile MOPS
6798 Plantation Pines Blvd
Fort Myers, Florida 33966

If you have financial constraints, scholarships and payment plans are available but limited in number.  Please contact Six Mile MOPS for more information via http://www.sixmilemops.org/contact.

If you have any questions/concerns about anything, please speak with Haley, Katelyn or email sixmilemops@gmail.com.


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First and Last Name *
Phone Number (123-456-7891) *
Email Address *
Address: Street and Zip Code *
Date of Birth (01/02/1988) *
Name of Spouse/Significant other, if applicable *
Will you be bringing children with you to MOPS Kids? Please list their Names/date of birth/and any allergies/medical conditions that we should be aware of to ensure safety and proper care. Example: "Clifford Johnson - 12/25/2009. Allergic to peanuts with an anaphylactic reaction. Please send along anything needed such as an EpiPen in ziploc gallon bag (along with change of clothes, diaper, wipes and labeled water cup only). *
Do you have a home church? If yes, where? *
How did you hear about Six Mile MOPS?
Are you currently pregnant? If so, when are you due? (This helps us plan for childcare and new baby celebrations) *
What are your interests?
Our MOPS group occasionally invites speakers to come and share about various topics of interest to moms. Do you have any speaker or topic recommendations?
What is your favorite way to relax? *
We want Six Mile MOPS to be a place that you can come and just relax. However, if you would like to serve, there are many ways that you can contribute to our group. Tell us what you enjoy doing. No pressure though :)
How do you prefer to be updated/informed about MOPS happenings? Please be specific: Facebook, Group Table Text, e-mail, other *
AUDIO/VISUAL RELEASE: I give my permission to use images/videos of me and/or my children for publicity or educational purposes by Six Mile MOPS / Fort Myers Evangelical Free Church on the church’s bulletin board, group website, publicity materials, etc. I understand that I am not entitled to any compensation or payment for their use. I understand that my child's name will not be used in conjunction with his/her picture *
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