Please fill in the form below or e-mail us at cincym4m@gmail.com.  Below is a sample application, just so you know more about our fees, membership information, and committee requirements.

  

Moms4Moms Membership Application

  
(Please note that information you submit may be distributed to our members only. If there is an issue with privacy, please circle any information you would not like to have circulated to our members.)
Name:                                                    Date of Birth:                        Spouse’s Name:
Address:                                                                   City:                   State:                 Zip:
Phone Number:                                         Email Address:
Hobbies, Interests & Additional Information (employment, home business, areas of special skills, etc):

   
Children’s names & Birthdates
Name:                                                     Birthday:
Name:                                                     Birthday:
Name:                                                     Birthday:
Name:                                                     Birthday:
 

ADDITIONAL INFORMATION
How did you hear about us?
Are you interested in joining a playgroup? 0 Yes 0 No
If you have e-mail do you check it regularly? 0 Yes 0 No
 

All members are asked to participate on one committee. Limited time is involved. Please number the committees in which you are most interested (1 = most interested, 4 = least interested).
0 Moms’ Events: (movies, dining out, crafts, educational, couples, families, cooking)

0 Kids’ Events: (crafts, educational tours, museum/library events, mom/tot lunch, etc.)

0 Parties: (spring, summer picnic, Halloween, holiday)

0 Philanthropy: (adopt-a-family project, family events, local charity support)
 

Waiver of Liability to Moms 4 Moms
I, the undersigned, understand that my participation and the participation of any members of my family in any Moms 4 Moms group function or program is completely voluntary and I hereby give permission for myself and my family to join in those functions or programs I shall hold harmless Moms 4 Moms and any Moms 4 Moms members, volunteers or representatives and/or the providers of any function or program location and/or materials from any accident, illness, or injury that occurs during or as a result of any function or program. I accept that the final responsibility for my safety and that of my family rests with me.
Member’s Signature:                                                                                  Date:
 
Dues are $30 for the year (January – December) and prorated at $2.50 per month if you are joining mid year. Please send this application along with a check for dues to our treasurer payable to Moms 4 Moms.